MEDICARE: KAREN MACQUIVEY 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	LW00005365	WA

General Provider Information

NPI Number	:	1881728897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN MACQUIVEY LICSW

Provider Business Mailing Address
First Line	:	6527 21ST AVE NE # 1
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-6947
Country	:	US
Telephone Number	:	206-335-2627
Fax Number	:

Provider Business Practice Location Address
First Line	:	6527 21ST AVE NE # 4
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-6947
Country	:	US
Telephone Number	:	206-285-9168
Fax Number	:

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

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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