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General NPI Number Information
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NPI Number | 1285442483
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Entity Type | Individual
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Provider Name | SEPTEMBER LIAM VALENTINE LSWAIC
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Gender |
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Dates
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Enumeration Date | 12/20/2024
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Last Update Date | 12/20/2024
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Provider Practice Location Address
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Address Line | 33400 9TH AVE S STE 100
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City | FEDERAL WAY
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State | WA
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Zip | 98003-2607
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Country | US
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Telephone | 206-567-7267
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Fax |
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Provider Business Mailing Address
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Address Line | 304 PUYALLUP AVE APT 332
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City | TACOMA
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State | WA
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Zip | 98421-1345
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Country | US
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Telephone | 734-846-9364
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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 | SC61586002
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License Number State | WA
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