Organization
LUTHERAN COMMUNITY SERVICES NORTHWEST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELIA CLARK (CREDENTIALING SPECIALIST)
(541) 201-3973
Entity
Organization
Contact information
Practice address
4040 S 188TH ST STE 300, SEATAC, WA 98188-5070
(206) 816-3253
(206) 838-2680
Mailing address
4040 S 188TH ST STE 300, SEATAC, WA 98188-5070
(206) 816-3253
(206) 838-2680
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
CERTIFICATE136
WA
1041C0700X
Clinical Social Worker
CERTIFICATE136
WA
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/17/2007
Last updated
06/27/2024
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