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General NPI Number Information
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NPI Number | 1730464223
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Entity Type | Individual
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Provider Name | DAWN MICHELLE RESVICK LICSW
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Gender | Female
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Dates
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Enumeration Date | 10/15/2011
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Last Update Date | 12/21/2023
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Provider Practice Location Address
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Address Line | 5925 162ND STREET CT E
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City | PUYALLUP
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State | WA
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Zip | 98375-9024
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Country | US
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Telephone | 253-459-3299
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Fax |
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Provider Business Mailing Address
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Address Line | 5925 162ND STREET CT E
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City | PUYALLUP
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State | WA
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Zip | 98375-9024
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Country | US
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Telephone | 253-459-3299
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | HP60222830
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CL60177124
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60236466
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License Number State | WA
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