Healthcare Provider Details

I. General information

NPI: 1558275685
Provider Name (Legal Business Name): SIMON SCHWARTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12610 76TH AVE S
SEATTLE WA
98178-4857
US

IV. Provider business mailing address

1222 SUMMIT AVE APT 305
SEATTLE WA
98101-2842
US

V. Phone/Fax

Practice location:
  • Phone: 206-427-4679
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: