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General NPI Number Information
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NPI Number | 1750516829
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Entity Type | Organization
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Legal Business Name | KING COUNTY SEXUAL ASSAULT RESOURCE CENTER
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/19/2009
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Provider Practice Location Address
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Address Line | 200 MILL AVE S STE 10
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City | RENTON
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State | WA
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Zip | 98057-2175
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Country | US
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Telephone | 425-226-5062
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Fax | 425-235-7422
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Provider Business Mailing Address
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Address Line | 200 MILL AVE S STE 10
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City | RENTON
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State | WA
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Zip | 98057-2175
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Country | US
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Telephone | 425-226-5062
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Fax | 425-235-7422
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Authorized Official
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Title or Position | DEPUTY EXECUTIVE DIRECTOR
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Name | MS. DEANN YAMAMOTO
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Credential | MA
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Telephone | 425-282-0349
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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 | LW00009759
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License Number State | WA
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