Individual
MS. JENNIFER ROSE TININENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1200 5TH AVE, SUITE 800, SEATTLE, WA 98101-3132
(206) 374-0109
(206) 374-0108
Mailing address
1200 5TH AVE, SUITE 800, SEATTLE, WA 98101-3132
(206) 374-0109
(206) 374-0108
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
PY60129683
WA
103TB0200X
Cognitive & Behavioral Psychologist
PY60129683
WA
103TC0700X
Clinical Psychologist
Primary
PY60129683
WA
103TC2200X
Clinical Child & Adolescent Psychologist
PY60129683
WA
Other
Enumeration date
12/01/2006
Last updated
07/01/2010
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