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NPI Code Detail

MEDICARE: KRISTAL MCKINNEY VARNADO LICSW

MEDICARE: KRISTAL MCKINNEY VARNADO LICSW
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
11041C0700XClinical Social WorkerLW60359575WA

General Provider Information

NPI Number : 1720419526
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTAL MCKINNEY VARNADO LICSW
Provider Business Mailing Address
First Line : 3715 S HUDSON ST STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2171
Country : US
Telephone Number : 206-819-6570
Fax Number :
Provider Business Practice Location Address
First Line : 3715 S HUDSON ST STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2171
Country : US
Telephone Number : 206-819-6570
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2013
Last Update Date : 08/20/2021

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Directions to “ KRISTAL MCKINNEY VARNADO LICSW” Practice Location

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