MEDICARE: BRENDA D FINNELL LCSW

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	34006881A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34006881A	OTHER	IN	STATE

General Provider Information

NPI Number	:	1841613130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENDA D FINNELL LCSW

Provider Business Mailing Address
First Line	:	3801 MIRANDA AVE
Second Line	:
City	:	PALO ALTO
State	:	CA
Zip	:	94304-1207
Country	:	US
Telephone Number	:	206-631-9472
Fax Number	:

Provider Business Practice Location Address
First Line	:	7709 12TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-2030
Country	:	US
Telephone Number	:	206-631-9472
Fax Number	:

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

Provider Enumeration Date	:	01/23/2014
Last Update Date	:	03/31/2021

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