MEDICARE: MS. LINDSEY T PINEDA 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	LW0009209	WA
2	104100000X	Social Worker	38359	TX

General Provider Information

NPI Number	:	1750368411
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LINDSEY T PINEDA LICSW

Provider Business Mailing Address
First Line	:	9116 196TH STREET CT E
Second Line	:
City	:	GRAHAM
State	:	WA
Zip	:	98338-6462
Country	:	US
Telephone Number	:	253-414-8250
Fax Number	:

Provider Business Practice Location Address
First Line	:	9600 VETERANS DR SW
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98493-0001
Country	:	US
Telephone Number	:	253-583-2321
Fax Number	:	253-589-4035

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	07/26/2019

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