Individual
PAULINE FATYGA WRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
3305 191ST ST SE, BOTHELL, WA 98012-7969
(312) 933-8414
Mailing address
3305 191ST ST SE, BOTHELL, WA 98012-7969
(312) 933-8414
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW60582677
WA
1041C0700X
Clinical Social Worker
LW60582677
WA
Other
Enumeration date
01/22/2020
Last updated
02/24/2020
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