Healthcare Provider Details

I. General information

NPI: 1376894584
Provider Name (Legal Business Name): DANIEL ADAM SORENSEN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LILLY RD NE
OLYMPIA WA
98506-5115
US

IV. Provider business mailing address

2415 S 320TH ST
FEDERAL WAY WA
98003-5442
US

V. Phone/Fax

Practice location:
  • Phone: 360-923-7000
  • Fax: 360-923-7089
Mailing address:
  • Phone: 253-839-1697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60507105
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: