Healthcare Provider Details

I. General information

NPI: 1780282830
Provider Name (Legal Business Name): TESSALA WREN WARHEIT-NIEMI LSWAIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2020
Last Update Date: 05/25/2026
Certification Date: 05/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NE 95TH ST
SEATTLE WA
98115-2426
US

IV. Provider business mailing address

2400 NE 95TH ST
SEATTLE WA
98115-2426
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-5050
  • Fax:
Mailing address:
  • Phone: 206-525-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSC61562713
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: