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1790027258 NPI number — MALYN TARA WHITE MSW, LICSWA

NPI Number: 1790027258
Health Care Provider/Practitioner: MALYN TARA WHITE MSW, LICSWA

Information about “1790027258” NPI (MALYN TARA WHITE MSW, LICSWA) exists in 1790027258 in HTML format HTML  |  1790027258 in plain Text format TXT  |  1790027258 in PDF (Portable Document Format) PDF  |  1790027258 in an XML format XML  formats.

NPI Number : 1790027258 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790027258",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "WHITE",
    "FirstName": "MALYN",
    "MiddleName": "TARA",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "MSW, LICSWA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "116 NW 191ST ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SHORELINE",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98177-3015",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "206-437-8118",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "325 9TH AVE",
    "SecondLinePracticeLocationAddress": "BOX: 359760",
    "PracticeLocationAddressCityName": "SEATTLE",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98104-2420",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "206-744-4028",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/22/2013",
    "LastUpdateDate": "03/22/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "1041C0700X",
        "TaxonomyName": "Clinical Social Worker",
        "LicenseNumber": "SC60335079",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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