Individual
XIMENA WIESSE EGOAVIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSWAIC
Contact information
Practice address
3808 S ANGELINE ST, SEATTLE, WA 98118-1712
(206) 735-5476
Mailing address
3808 S ANGELINE ST, SEATTLE, WA 98118-1712
(206) 735-5476
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SC 60433152
WA
Other
Enumeration date
10/28/2014
Last updated
07/20/2020
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