MEDICARE: RACHEL STEWART 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
1	1041C0700X	Clinical Social Worker	LW 60531219	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LW 60531219	OTHER	WA	LICSW

General Provider Information

NPI Number	:	1730555731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL STEWART LICSW

Provider Business Mailing Address
First Line	:	2607 WESTERN AVE
Second Line	:	APT 154
City	:	SEATTLE
State	:	WA
Zip	:	98121-1326
Country	:	US
Telephone Number	:	206-227-2646
Fax Number	:

Provider Business Practice Location Address
First Line	:	2607 WESTERN AVE
Second Line	:	APT 154
City	:	SEATTLE
State	:	WA
Zip	:	98121-1326
Country	:	US
Telephone Number	:	206-227-2646
Fax Number	:

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

Provider Enumeration Date	:	08/13/2015
Last Update Date	:	08/13/2015

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