Individual
MR. JASON IAN SIEGEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 744-9686
Mailing address
325 9TH AVE # 359797, SEATTLE, WA 98104-2499
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LW61434264
WA
1041C0700X
Clinical Social Worker
Primary
LW61434264
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00082079
—
NY
05
—
833688950
—
NY
Enumeration date
10/05/2010
Last updated
08/28/2023
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