Provider Demographics
NPI:1437427184
Name:TREBBY, JENNIFER L (MSW)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:TREBBY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6026 FAUNTLEROY WAY SW UNIT B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1615
Mailing Address - Country:US
Mailing Address - Phone:781-640-8753
Mailing Address - Fax:866-392-7931
Practice Address - Street 1:5426 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1513
Practice Address - Country:US
Practice Address - Phone:206-590-0917
Practice Address - Fax:866-392-7931
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW603119431041C0700X
VA09040077781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1437427184Medicaid