MEDICARE: MS. VICTORIA L. COEN MSW, LICSW

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	LW00005788	WA

General Provider Information

NPI Number	:	1316231343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VICTORIA L. COEN MSW, LICSW

Provider Business Mailing Address
First Line	:	5413 MERIDIAN AVE N
Second Line	:	SUITE A
City	:	SEATTLE
State	:	WA
Zip	:	98103-6168
Country	:	US
Telephone Number	:	206-284-1435
Fax Number	:

Provider Business Practice Location Address
First Line	:	5413 MERIDIAN AVE N
Second Line	:	SUITE A
City	:	SEATTLE
State	:	WA
Zip	:	98103-6168
Country	:	US
Telephone Number	:	206-284-1435
Fax Number	:

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

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	06/07/2011

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