Healthcare Provider Details

I. General information

NPI: 1679743785
Provider Name (Legal Business Name): ELIZABETH FRANCES QUINN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1191 2ND AVE STE 680
SEATTLE WA
98101-3433
US

IV. Provider business mailing address

1191 2ND AVE STE 680
SEATTLE WA
98101-3433
US

V. Phone/Fax

Practice location:
  • Phone: 206-826-3040
  • Fax: 866-894-7425
Mailing address:
  • Phone: 206-826-3040
  • Fax: 866-894-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00008457
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: