Healthcare Provider Details

I. General information

NPI: 1598038473
Provider Name (Legal Business Name): CRISTINA NADINE MALDONADO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2012
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16260 BOTHELL WAY NE
LAKE FOREST PARK WA
98155-6760
US

IV. Provider business mailing address

16260 BOTHELL WAY NE
LAKE FOREST PARK WA
98155-6760
US

V. Phone/Fax

Practice location:
  • Phone: 509-521-8968
  • Fax:
Mailing address:
  • Phone: 509-521-8968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.60252026
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: