Healthcare Provider Details

I. General information

NPI: 1255934550
Provider Name (Legal Business Name): ANJULIE SEMENCHUK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 14TH AVE APT 103
SEATTLE WA
98122-2663
US

IV. Provider business mailing address

1211 E DENNY WAY # A34
SEATTLE WA
98122-2516
US

V. Phone/Fax

Practice location:
  • Phone: 206-580-1030
  • Fax:
Mailing address:
  • Phone: 206-580-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC60888422
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: