MEDICARE: MS. KAROLINA WRIGHT WILLIAMS LICSW, MDIV

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	603 481 879	WA

General Provider Information

NPI Number	:	1326434697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAROLINA WRIGHT WILLIAMS LICSW, MDIV

Provider Business Mailing Address
First Line	:	5100 S DAWSON ST STE 103
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2100
Country	:	US
Telephone Number	:	512-789-3709
Fax Number	:

Provider Business Practice Location Address
First Line	:	4819 S OREGON ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1449
Country	:	US
Telephone Number	:	512-789-3709
Fax Number	:

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

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	04/13/2015

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