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Organization
ONE HEART WILD
Active
Organization
ONE HEART WILD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA LEE NEWELL LICSW (CLINICAL DIRECTOR)
(425) 280-6508
Entity
Organization
Contact information
Practice address
12620 WILLAMETTE MERIDIAN RD NW, SILVERDALE, WA 98383-9701
(360) 509-2948
(360) 337-7433
Mailing address
12620 WILLAMETTE MERIDIAN RD NW, SILVERDALE, WA 98383-9701
(360) 509-2948
(360) 337-7433
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LICSW
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2083710
—
WA
Enumeration date
05/15/2018
Last updated
11/03/2023
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