Individual
CAROLE FRAN KOSTURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
19031 33RD AVE W STE 303, LYNNWOOD, WA 98036-4731
(425) 640-7919
Mailing address
5721 92ND AVE SE, MERCER ISLAND, WA 98040-5034
(206) 232-1990
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00004556
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20352989
EIN
WA
Enumeration date
08/28/2006
Last updated
07/08/2007
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