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NPI Code Detail

MEDICARE: LISA E'LYN KARTIGANER MSW, LICSW, ACSW

MEDICARE: LISA E'LYN KARTIGANER MSW, LICSW, ACSW
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
11041C0700XClinical Social WorkerLW00004894WA

General Provider Information

NPI Number : 1295849040
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA E'LYN KARTIGANER MSW, LICSW, ACSW
Provider Business Mailing Address
First Line : 1500 LAKESIDE AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-4028
Country : US
Telephone Number : 206-851-4327
Fax Number :
Provider Business Practice Location Address
First Line : 6400 SOUTHCENTER BLVD
Second Line :
City : TUKWILA
State : WA
Zip : 98188-2547
Country : US
Telephone Number : 206-901-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/30/2024

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