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General NPI Number Information
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NPI Number | 1518825785
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Entity Type | Individual
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Provider Name | SIDNEY MIYOKO GREENUP
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Gender |
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 2101 LITTLE MOUNTAIN LN
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City | MOUNT VERNON
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State | WA
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Zip | 98274-8752
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Country | US
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Telephone | 360-428-2622
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Fax |
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Provider Business Mailing Address
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Address Line | 430 W STUART RD UNIT 313
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City | BELLINGHAM
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State | WA
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Zip | 98226-1246
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Country | US
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Telephone | 719-821-6252
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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 | SWIA.SC.70015305
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License Number State | WA
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