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NPI Code Detail

MEDICARE: DEREK LOW MPH, LICSW

MEDICARE: DEREK LOW MPH, 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
11041C0700XClinical Social WorkerL6970OR
21041C0700XClinical Social WorkerLW61207023WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1L6970OTHERORLCSW

General Provider Information

NPI Number : 1881004711
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEREK LOW MPH, LICSW
Provider Business Mailing Address
First Line : 1200 12TH AVE S STE 901
Second Line :
City : SEATTLE
State : WA
Zip : 98144-2712
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1629 N 45TH ST
Second Line :
City : SEATTLE
State : WA
Zip : 98103-6701
Country : US
Telephone Number : 206-633-7650
Fax Number : 206-633-3113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2014
Last Update Date : 05/28/2026

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