MEDICARE: HANNAH LEAH LASSMAN 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	60707473	WA

General Provider Information

NPI Number	:	1558887331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH LEAH LASSMAN LICSW

Provider Business Mailing Address
First Line	:	2617B NW 57TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3246
Country	:	US
Telephone Number	:	206-790-0552
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617B NW 57TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3246
Country	:	US
Telephone Number	:	206-790-0552
Fax Number	:

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

Provider Enumeration Date	:	08/14/2017
Last Update Date	:	08/14/2017

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