MEDICARE: LIANNE CAROLINE BIRK LSWAIC

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	SC61578277	WA
2	104100000X	Social Worker	SC61578277	WA

General Provider Information

NPI Number	:	1821804634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIANNE CAROLINE BIRK LSWAIC

Provider Business Mailing Address
First Line	:	956 10TH AVE E APT 102
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4558
Country	:	US
Telephone Number	:	206-335-1814
Fax Number	:

Provider Business Practice Location Address
First Line	:	956 10TH AVE E APT 102
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-4558
Country	:	US
Telephone Number	:	206-335-1814
Fax Number	:

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

Provider Enumeration Date	:	12/06/2024
Last Update Date	:	03/07/2025

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