MEDICARE: DAVID FERNANDEZ

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	SC61553152	WA

General Provider Information

NPI Number	:	1376238857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID FERNANDEZ

Provider Business Mailing Address
First Line	:	2405 NW 67TH ST UNIT 202
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98117-5857
Country	:	US
Telephone Number	:	908-246-5102
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W MERCER ST # E412
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98119-3995
Country	:	US
Telephone Number	:	206-765-8265
Fax Number	:

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

Provider Enumeration Date	:	04/10/2023
Last Update Date	:	12/06/2025

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Directions to “ DAVID FERNANDEZ ” Practice Location

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