Provider Demographics
NPI:1316744477
Name:SOLBERG, JODIE LYNN (CHT)
Entity type:Individual
Prefix:
First Name:JODIE
Middle Name:LYNN
Last Name:SOLBERG
Suffix:
Gender:
Credentials:CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:CONCRETE
Mailing Address - State:WA
Mailing Address - Zip Code:98237-0247
Mailing Address - Country:US
Mailing Address - Phone:425-608-1867
Mailing Address - Fax:425-845-2375
Practice Address - Street 1:7558 PRESSENTIN RANCH DR
Practice Address - Street 2:
Practice Address - City:CONCRETE
Practice Address - State:WA
Practice Address - Zip Code:98237-8803
Practice Address - Country:US
Practice Address - Phone:425-608-1867
Practice Address - Fax:425-845-2375
Is Sole Proprietor?:No
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHP61019271101Y00000X, 174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No174H00000XOther Service ProvidersHealth Educator