Healthcare Provider Details

I. General information

NPI: 1720734783
Provider Name (Legal Business Name): CHRISTINE SOGN LICSW, SUDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2022
Last Update Date: 03/21/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

V. Phone/Fax

Practice location:
  • Phone: 206-604-1946
  • Fax:
Mailing address:
  • Phone: 206-987-0208
  • Fax:

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 NumberLW60332685
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: