Individual
LYNN HACKSTAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6505 216TH ST SW STE 100, MOUNTLAKE TERRACE, WA 98043-2089
(425) 640-7009
Mailing address
1021 SE EVERETT MALL WAY UNIT L, EVERETT, WA 98208-2809
(310) 619-5085
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60995388
WA
363A00000X
Physician Assistant
LCS11925
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60995388
INDEPENDENT CLINICAL SOCIAL WORKER LICENSE
WA
Enumeration date
06/13/2007
Last updated
07/30/2021
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