Provider Demographics
NPI:1730517566
Name:SALSTROM, ZANDI ROSE (ATR-BC, LMHC, LCPC)
Entity type:Individual
Prefix:
First Name:ZANDI
Middle Name:ROSE
Last Name:SALSTROM
Suffix:
Gender:F
Credentials:ATR-BC, LMHC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 LAKESIDE AVE # A73
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-6551
Mailing Address - Country:US
Mailing Address - Phone:775-298-5392
Mailing Address - Fax:206-316-1357
Practice Address - Street 1:140 LAKESIDE AVE # A73
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-6551
Practice Address - Country:US
Practice Address - Phone:775-298-5392
Practice Address - Fax:206-316-1357
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60480950101YM0800X
NVCP0304101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
83-2673448OtherFEIN