Provider Demographics
NPI:1669520748
Name:KAFTAN, JUDITH HELEN (MSW)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:HELEN
Last Name:KAFTAN
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 1:2719 E MADISON ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4752
Mailing Address - Country:US
Mailing Address - Phone:206-325-5355
Mailing Address - Fax:
Practice Address - Street 1:2719 E MADISON ST
Practice Address - Street 2:SUITE 303
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4752
Practice Address - Country:US
Practice Address - Phone:206-325-5355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000048021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical