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NPI 1720555410

NPI 1720555410 : INIOBONG FRANCIS UDOUNWA MSW LCSW : SEATTLE, WA

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General NPI Number Information
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    NPI Number           |    1720555410
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    Entity Type          |    Individual 
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    Provider Name        |    INIOBONG FRANCIS UDOUNWA MSW LCSW
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/31/2018
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    Last Update Date     |    04/26/2022
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Provider Practice Location Address
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    Address Line         |    1660 S COLUMBIA WAY 
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    City                 |    SEATTLE
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    State                |    WA
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    Zip                  |    98108-1532
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    Country              |    US
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    Telephone            |    206-762-1010
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1660 S COLUMBIAN WAY 
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    City                 |    SEATTLE
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    State                |    WA
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    Zip                  |    98108-1532
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    Country              |    US
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    Telephone            |    206-762-1010
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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       |    226608
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    License Number State |    MA
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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       |    14583
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    License Number State |    SC
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