Healthcare Provider Details

I. General information

NPI: 1518899202
Provider Name (Legal Business Name): MARY CAROLINE CARNEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 NICKERSON ST STE 305
SEATTLE WA
98109-1658
US

IV. Provider business mailing address

421 BELLEVUE AVE E APT 201
SEATTLE WA
98102-6814
US

V. Phone/Fax

Practice location:
  • Phone: 206-222-8266
  • Fax:
Mailing address:
  • Phone: 615-767-6973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61591476
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: