Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CB00029723 | WA |
N | 1041C0700X | Clinical Social Worker | 020704-LW-0000-7328 | WA |
NPI | 1003839259 |
---|---|
Provider Name | Ms. Susan M Valentine |
First Address | Seattle, WA 98109-4518 |
Second Address | Seattle, WA 98109-4518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 08/07/2007 |