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General NPI Number Information
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NPI Number | 1104285683
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Entity Type | Individual
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Provider Name | PATRICIA KENNEDY M.S.W.
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Gender | Female
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Dates
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Enumeration Date | 02/12/2016
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Last Update Date | 02/12/2016
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Provider Practice Location Address
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Address Line | 401 5TH AVE SUITE 1000
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City | SEATTLE
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State | WA
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Zip | 98104-1818
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Country | US
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Telephone | 206-263-8361
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Fax | 206-296-3808
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Provider Business Mailing Address
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Address Line | PO BOX 1215
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City | NORTH BEND
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State | WA
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Zip | 98045-1215
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Country | US
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Telephone | 425-463-5149
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Fax | 425-831-4503
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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 | LW00004428
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License Number State | WA
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