Healthcare Provider Details

I. General information

NPI: 1215482401
Provider Name (Legal Business Name): DAWN MARIE CARMELITA ESCARCEGA MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAWN MARIE CARMELITA BARRETT, VANHOOF

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 08/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16549 AURORA AVE N
SHORELINE WA
98133-5308
US

IV. Provider business mailing address

16549 AURORA AVE N
SHORELINE WA
98133-5308
US

V. Phone/Fax

Practice location:
  • Phone: 206-533-2600
  • Fax:
Mailing address:
  • Phone: 206-533-2600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC60652563
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: