Provider Demographics
NPI:1356173330
Name:WATTNEM, JESSICA SIGNE (MA, LMFTA)
Entity type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:SIGNE
Last Name:WATTNEM
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23119 NE 8TH ST UNIT 3
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-7347
Mailing Address - Country:US
Mailing Address - Phone:425-370-9219
Mailing Address - Fax:
Practice Address - Street 1:23119 NE 8TH ST UNIT 3
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-7347
Practice Address - Country:US
Practice Address - Phone:425-370-9219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMFTA.MG.70023302106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist