MEDICARE: NOAH STARER 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	LW00006260

General Provider Information

NPI Number	:	1447864889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NOAH STARER LICSW

Provider Business Mailing Address
First Line	:	3703 S EDMUNDS ST # 32
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1728
Country	:	US
Telephone Number	:	206-317-1971
Fax Number	:

Provider Business Practice Location Address
First Line	:	3719 S ANGELINE ST APT 2
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1761
Country	:	US
Telephone Number	:	206-930-8940
Fax Number	:

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

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	07/13/2021

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