Basic Information
| Provider Information | |||||||||
| NPI: | 1578675187 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PANELL | ||||||||
| FirstName: | JANETTE | ||||||||
| MiddleName: | LATONYA | ||||||||
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| Credential: | MA ED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4713 S 4TH AVE | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982032532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253391599 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3322 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982014425 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4253497289 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 020701 RC00033932 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.