Provider Demographics
NPI:1386109981
Name:ZIMMERMAN, ASHLEY MARIE LORRAINE (MA, LMHCA, MHP, RYT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE LORRAINE
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MA, LMHCA, MHP, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6006 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6516
Mailing Address - Country:US
Mailing Address - Phone:206-390-0729
Mailing Address - Fax:
Practice Address - Street 1:753 N 35TH ST STE 105
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8889
Practice Address - Country:US
Practice Address - Phone:206-390-0729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-07
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60590935101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health