Individual
MR. MARK J NIEZGODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
4219 S OTHELLO ST APT 517, SEATTLE, WA 98118-3886
(206) 321-3997
Mailing address
4219 S OTHELLO ST APT 517, SEATTLE, WA 98118-3886
(206) 321-3997
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60991792
WA
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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