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General NPI Number Information
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NPI Number | 1871985721
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Entity Type | Organization
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Legal Business Name | MOSS & OSTERGAARD
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Dates
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Enumeration Date | 03/02/2015
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Last Update Date | 03/02/2015
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Provider Practice Location Address
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Address Line | 1811 QUEEN ANNE AVE N 204
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City | SEATTLE
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State | WA
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Zip | 98109-2850
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Country | US
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Telephone | 206-283-3374
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Fax |
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Provider Business Mailing Address
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Address Line | 1811 QUEEN ANNE AVE N 204
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City | SEATTLE
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State | WA
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Zip | 98109-2850
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Country | US
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Telephone | 206-283-3374
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Fax |
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Authorized Official
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Title or Position | PSYCHOTHERAPIST/PARTNER
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Name | MS. LAURIE RUTH MOSS
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Credential | M.A., L.M.H.C.
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Telephone | 206-283-3374
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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 | LW00004305
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License Number State | WA
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