Individual
ELLIOT E GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1637 CALIFORNIA AVE SW APT 4, SEATTLE, WA 98116-1654
(206) 545-2818
Mailing address
1637 CALIFORNIA AVE SW APT 4, SEATTLE, WA 98116-1654
(206) 545-2818
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00006378
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LW00006378
CREDENTIAL NUMBER
WA
Enumeration date
04/18/2012
Last updated
04/18/2012
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