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NPI 1922151729

NPI 1922151729 : INDU PANDALAI MSW, SW ASS : BELLEVUE, WA

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General NPI Number Information
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    NPI Number           |    1922151729
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    Entity Type          |    Individual 
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    Provider Name        |    INDU PANDALAI MSW, SW ASS
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/18/2007
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    Last Update Date     |    09/18/2013
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Provider Practice Location Address
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    Address Line         |    14216 NE 21ST ST 
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    City                 |    BELLEVUE
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    State                |    WA
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    Zip                  |    98007-3720
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    Country              |    US
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    Telephone            |    425-653-4900
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    Fax                  |    425-653-4910
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Provider Business Mailing Address
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    Address Line         |    1600 E OLIVE ST SEATTLE MENTAL HEALTH
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    City                 |    SEATTLE
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    State                |    WA
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    Zip                  |    98122-2735
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    Country              |    US
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    Telephone            |    206-302-2200
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    Fax                  |    206-302-2210
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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       |    SA60214788
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    License Number State |    WA
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Taxonomy #2
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    SA60214788
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    License Number State |    WA
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