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General NPI Number Information
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NPI Number | 1174313274
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Entity Type | Individual
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Provider Name | QUANAH YELLOW CLOUD LMSW
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Gender | Male
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Dates
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Enumeration Date | 05/12/2025
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 123 NW 36TH ST STE 210
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City | SEATTLE
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State | WA
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Zip | 98107-4959
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Country | US
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Telephone | 206-402-5767
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Fax |
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Provider Business Mailing Address
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Address Line | 65 IRVINGTON ST
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City | NEW HAVEN
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State | CT
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Zip | 06513-4619
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Country | US
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Telephone | 203-214-8194
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 11044
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SWIA.SC.70006784
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License Number State | WA
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