Individual
KEITH WILLIAM JOHANNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
2028 3RD AVE, SEATTLE, WA 98121-2413
(206) 520-5000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 520-5700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LW00009718
WA
1041C0700X
Clinical Social Worker
Primary
LW00009718
WA
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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