Provider Demographics
NPI:1356700199
Name:ZANDELL, STEFANIE (CDPT)
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:ZANDELL
Suffix:
Gender:F
Credentials:CDPT
Other - Prefix:
Other - First Name:STEF
Other - Middle Name:
Other - Last Name:ZANDELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8825 34TH AVE NE
Mailing Address - Street 2:STE L #127
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271
Mailing Address - Country:US
Mailing Address - Phone:509-590-9406
Mailing Address - Fax:
Practice Address - Street 1:3322 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4425
Practice Address - Country:US
Practice Address - Phone:425-349-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker