Provider Demographics
NPI:1730416785
Name:SERAGE, JEFFREY BURDETTE (LMHC)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:BURDETTE
Last Name:SERAGE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7110 44TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-2031
Mailing Address - Country:US
Mailing Address - Phone:206-271-1988
Mailing Address - Fax:206-969-0908
Practice Address - Street 1:1800 WESTLAKE AVE N
Practice Address - Street 2:SUITE 303
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2782
Practice Address - Country:US
Practice Address - Phone:206-271-1988
Practice Address - Fax:206-969-0908
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60159999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health