Healthcare Provider Details

I. General information

NPI: 1306132816
Provider Name (Legal Business Name): SEEMA R MHATRE LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2011
Last Update Date: 06/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE M/S OBCC
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

2101 E YESLER WAY SUITE 100
SEATTLE WA
98122-5959
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-7222
  • Fax: 206-329-9764
Mailing address:
  • Phone: 206-987-7222
  • Fax: 206-329-9764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00009491
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: