Individual
LAURA GRISSOM SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2100 WESTLAKE AVE N, SEATTLE, WA 98109-5802
(206) 858-1177
Mailing address
2926 1ST AVE N, SEATTLE, WA 98109-1703
(919) 943-6452
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
60509108
WA
1041C0700X
Clinical Social Worker
Primary
C007635
NC
Other
Enumeration date
08/02/2013
Last updated
11/13/2015
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