Provider Demographics
NPI:1679390181
Name:GILLIS, ANNE (MA, LMFTA)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:GILLIS
Suffix:
Gender:F
Credentials:MA, LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 EASTLAKE AVE E STE 220
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3086
Mailing Address - Country:US
Mailing Address - Phone:206-953-0771
Mailing Address - Fax:
Practice Address - Street 1:2815 EASTLAKE AVE E STE 220
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3086
Practice Address - Country:US
Practice Address - Phone:206-953-0771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-25
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist