Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | ||
N | 104100000X | Social Worker | CP60587615 | WA |
NPI | 1003383662 |
---|---|
Provider Name | Steven Bass |
First Address | Seattle, WA 98134-1618 |
Second Address | Seattle, WA 98134-1618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2018 |
Last Update Date | 25/06/2019 |