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1255473831

NPI Code Detail

MEDICARE: DEREK A. CRAIN MSW

MEDICARE: DEREK A. CRAIN MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	LW00009354	WA
2	1041C0700X	Clinical Social Worker	10590-C	NV
3	1041C0700X	Clinical Social Worker	111458	TX
4	1041C0700X	Clinical Social Worker	13348744-3501	UT
5	1041C0700X	Clinical Social Worker	I.2304933	OH
6	1041C0700X	Clinical Social Worker	L8526	OR
7	1041C0700X	Clinical Social Worker	32494	MN
8	1041C0700X	Clinical Social Worker	SW21414	FL
9	1041C0700X	Clinical Social Worker	CSW.09929019	CO
10	1041C0700X	Clinical Social Worker	SWB-2023-0376	NM
11	1041C0700X	Clinical Social Worker	149025864	IL
12	1041C0700X	Clinical Social Worker	LCSW-43728	ID
13	1041C0700X	Clinical Social Worker	LCSW-21295	AZ

General Provider Information

NPI Number	:	1255473831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEREK A. CRAIN MSW

Provider Business Mailing Address
First Line	:	6505 216TH ST SW STE 100
Second Line	:
City	:	MOUNTLAKE TERRACE
State	:	WA
Zip	:	98043-2089
Country	:	US
Telephone Number	:	425-640-7009
Fax Number	:	425-678-6455

Provider Business Practice Location Address
First Line	:	6505 216TH ST SW STE 100
Second Line	:
City	:	MOUNTLAKE TERRACE
State	:	WA
Zip	:	98043-2089
Country	:	US
Telephone Number	:	425-640-7009
Fax Number	:	425-678-6455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	11/20/2023

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Directions to “ DEREK A. CRAIN MSW” Practice Location

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