MEDICARE: MS. CATHERINE J TRESTRAIL MSW, ACSW, CDP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	RC00004588	WA

General Provider Information

NPI Number	:	1295973436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CATHERINE J TRESTRAIL MSW, ACSW, CDP

Provider Business Mailing Address
First Line	:	1553 N 38TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8161
Country	:	US
Telephone Number	:	206-632-1592
Fax Number	:

Provider Business Practice Location Address
First Line	:	4649 SUNNYSIDE AVE N
Second Line	:	SUITE 200
City	:	SEATTLE
State	:	WA
Zip	:	98103-6900
Country	:	US
Telephone Number	:	206-632-1592
Fax Number	:

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

Provider Enumeration Date	:	01/26/2009
Last Update Date	:	01/26/2009

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