Healthcare Provider Details

I. General information

NPI: 1790695070
Provider Name (Legal Business Name): RENEE CHRISTINA HUNTER MACLEOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

2414 SW ANDOVER ST STE D210
SEATTLE WA
98106-1162
US

IV. Provider business mailing address

6523 CALIFORNIA AVE SW
SEATTLE WA
98136-1833
US

V. Phone/Fax

Practice location:
  • Phone: 206-580-3895
  • Fax: 206-374-2958
Mailing address:
  • Phone: 206-580-3895
  • Fax: 206-374-2958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.70157933
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: