MEDICARE: MS. CYNTHIA ANN SCULLEY MSW

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	LW70039961	WA

General Provider Information

NPI Number	:	1912252040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA ANN SCULLEY MSW

Provider Business Mailing Address
First Line	:	3616 34TH AVE S UNIT 402
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-5193
Country	:	US
Telephone Number	:	206-841-1748
Fax Number	:

Provider Business Practice Location Address
First Line	:	3616 34TH AVE S UNIT 402
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98144-5193
Country	:	US
Telephone Number	:	206-841-1748
Fax Number	:

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

Provider Enumeration Date	:	07/15/2012
Last Update Date	:	02/09/2026

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