MEDICARE: AMAIRANI DOMINGUEZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	61358546	WA

General Provider Information

NPI Number	:	1063354918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMAIRANI DOMINGUEZ

Provider Business Mailing Address
First Line	:	13846 NE 8TH ST APT A102
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-3466
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 9TH AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98104-2420
Country	:	US
Telephone Number	:	206-744-5039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “ AMAIRANI DOMINGUEZ ” Practice Location

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