Individual
HIEN-THAO PHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW, MSW
Contact information
Practice address
3815 S OTHELLO ST, SEATTLE, WA 98118-3510
(206) 788-3500
Mailing address
PO BOX 3007, SEATTLE, WA 98114-3007
(206) 788-3500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SC60726290
WA
104100000X
Social Worker
CG60183725
WA
104100000X
Social Worker
Primary
LW61296741
WA
1041C0700X
Clinical Social Worker
SC60726290
WA
Other
Enumeration date
07/14/2016
Last updated
08/03/2022
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