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Individual

JUSTIN P IBRAHIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW, MSW

Contact information

Practice address
7216 S RYAN ST, SEATTLE, WA 98178-2618
(425) 477-9777
Mailing address
2501 SW TRENTON ST # 1011, SEATTLE, WA 98106-3206
(425) 477-9777

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
SC61172478
WA
1041C0700X
Clinical Social Worker
Primary
LW61533180
WA

Other

Enumeration date
06/08/2018
Last updated
07/24/2024
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