Provider Demographics
NPI:1851645352
Name:PALMER, JODI ANN (PSYD, LMHC)
Entity type:Individual
Prefix:DR
First Name:JODI
Middle Name:ANN
Last Name:PALMER
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 OLIVE WAY
Mailing Address - Street 2:APT 2608
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-3743
Mailing Address - Country:US
Mailing Address - Phone:213-618-1036
Mailing Address - Fax:
Practice Address - Street 1:1700 WESTLAKE AVE N
Practice Address - Street 2:SUITE 650
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3012
Practice Address - Country:US
Practice Address - Phone:206-283-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-05
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60310029101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health