MEDICARE: JOHN SEATON WHITE LICSW, CMHS

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	101Y00000X	Counselor	CG60185704	WA
2	1041C0700X	Clinical Social Worker	LW60754230	WA
3	1041C0700X	Clinical Social Worker	SC60549720	WA
4	101YM0800X	Mental Health Counselor	CG60185704	WA

General Provider Information

NPI Number	:	1720337579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SEATON WHITE LICSW, CMHS

Provider Business Mailing Address
First Line	:	6702 N 89TH LOOP
Second Line	:
City	:	CAMAS
State	:	WA
Zip	:	98607-6753
Country	:	US
Telephone Number	:	425-785-7566
Fax Number	:	206-899-1951

Provider Business Practice Location Address
First Line	:	2027 196TH ST SW STE A205
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-7073
Country	:	US
Telephone Number	:	360-553-1548
Fax Number	:	206-899-1951

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

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	12/29/2025

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