Provider Demographics
NPI:1144948365
Name:GRITSCH, KENDRA METZ (MSW, LSWAIC)
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:METZ
Last Name:GRITSCH
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12708 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-4222
Mailing Address - Country:US
Mailing Address - Phone:206-465-1851
Mailing Address - Fax:
Practice Address - Street 1:12708 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98177-4222
Practice Address - Country:US
Practice Address - Phone:206-465-1851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61249878101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor