Healthcare Provider Details

I. General information

NPI: 1700556412
Provider Name (Legal Business Name): RONALD COLIN SEXTON MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: COLIN SEXTON

II. Dates (important events)

Enumeration Date: 09/14/2021
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4228 DECATUR PL S
SEATTLE WA
98108-1456
US

IV. Provider business mailing address

4228 DECATUR PL S
SEATTLE WA
98108-1456
US

V. Phone/Fax

Practice location:
  • Phone: 206-399-8492
  • Fax:
Mailing address:
  • Phone: 206-399-8492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW60976437
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: