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NPI Code Detail

MEDICARE: DARREN WENZ LICSW

MEDICARE: DARREN WENZ 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 WorkerLW 60185893WA

General Provider Information

NPI Number : 1871964874
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARREN WENZ LICSW
Provider Business Mailing Address
First Line : 2002 65TH AVE W
Second Line :
City : FIRCREST
State : WA
Zip : 98466-6200
Country : US
Telephone Number : 253-565-0274
Fax Number :
Provider Business Practice Location Address
First Line : 2002 65TH AVE W
Second Line :
City : FIRCREST
State : WA
Zip : 98466-6200
Country : US
Telephone Number : 253-565-0274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2015
Last Update Date : 10/15/2015

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Directions to “ DARREN WENZ LICSW” Practice Location

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