MEDICARE: MRS. KASSANDRA ALLEN 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		WA

General Provider Information

NPI Number	:	1316414949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KASSANDRA ALLEN LICSW

Provider Business Mailing Address
First Line	:	16619 96TH AVENUE CT E
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98375-2044
Country	:	US
Telephone Number	:	253-306-7010
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 BROADWAY
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98402-3778
Country	:	US
Telephone Number	:	253-640-4049
Fax Number	:

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

Provider Enumeration Date	:	11/01/2018
Last Update Date	:	03/03/2026

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