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General NPI Number Information
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NPI Number | 1912715848
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Entity Type | Individual
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Provider Name | CORINNE MCINTYRE MSW
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Gender | Female
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Dates
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Enumeration Date | 12/23/2024
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 4122 FACTORIA BLVD SE
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City | BELLEVUE
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State | WA
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Zip | 98006-4200
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Country | US
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Telephone | 425-590-9419
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Fax |
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Provider Business Mailing Address
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Address Line | 23105 MERIDIAN AVE S
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City | BOTHELL
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State | WA
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Zip | 98021-8719
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Country | US
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Telephone | 425-344-7551
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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 | 61560131
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License Number State | WA
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