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General NPI Number Information
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NPI Number | 1003346701
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Entity Type | Individual
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Provider Name | DERRICK D'ABREAU LICSW
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Gender | Male
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | PO BOX 4092
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City | SPANAWAY
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State | WA
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Zip | 98387-4006
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Country | US
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Telephone | 425-272-5986
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Fax | 253-352-4036
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Provider Business Mailing Address
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Address Line | 21905 MOUNTAIN HWY E
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City | SPANAWAY
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State | WA
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Zip | 98387-8570
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Country | US
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Telephone | 425-272-5986
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Fax | 253-342-4036
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW61169987
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License Number State | WA
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