Active NPI
Jenaya Lee Van Horn-Dobberstein, LMFT
- Marriage & Family Therapist
- Tukwila, WA
National Provider Identifier
1033327374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- #LF00002264
- Practice address
- 15455 65TH Ave S
Tukwila, WA 98188-2534 - Phone
- (206) 721-5170
- Fax
- (360) 575-1950
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | #LF00002264 | WA | Primary |
Addresses
Primary practice location
15455 65TH Ave S
Tukwila, WA 98188-2534
Mailing address
PO Box 2429
Longview, WA 98632-8486
Phone (360) 353-9494
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| #LF00002264 | Other | WA | LMFT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| #LF00002264 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483920000000",
"number": "1033327374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2429",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986328486",
"telephone_number": "360-353-9494",
"fax_number": "360-353-9440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15455 65TH AVE S",
"city": "TUKWILA",
"state": "WA",
"postal_code": "981882534",
"telephone_number": "206-721-5170",
"fax_number": "360-575-1950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN HORN-DOBBERSTEIN",
"first_name": "JENAYA",
"middle_name": "LEE",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2017-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "#LF00002264",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LMFT",
"identifier": "#LF00002264",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tukwila, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.