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General NPI Number Information
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NPI Number | 1124645445
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Entity Type | Individual
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Provider Name | CAITLIN MORETZ LSWAA
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Gender | Female
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 1417 NW 54TH ST
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City | SEATTLE
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State | WA
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Zip | 98107-3570
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Country | US
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Telephone | 253-470-8154
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 NW LEARY WAY STE 400
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City | SEATTLE
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State | WA
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Zip | 98107-5138
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Country | US
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Telephone | 253-470-8154
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Fax |
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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 | 6403613711
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License Number State | WA
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