Healthcare Provider Details

I. General information

NPI: 1053417048
Provider Name (Legal Business Name): H. PAGE BALDWIN MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4245 ROOSEVELT WAY BOX 354760
SEATTLE WA
98195-0001
US

IV. Provider business mailing address

PO BOX 24366 BOX 359107
SEATTLE WA
98124-0366
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-4394
  • Fax: 206-598-4939
Mailing address:
  • Phone: 206-598-0502
  • Fax: 206-598-0516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00005013
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: