Individual
GINA GROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
2015 NW 61ST ST, SEATTLE, WA 98107-2403
(414) 530-2547
Mailing address
2015 NW 61ST ST, SEATTLE, WA 98107-2403
(414) 530-2547
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
1092-122
WI
1041C0700X
Clinical Social Worker
1092-122
WI
1041C0700X
Clinical Social Worker
Primary
LW61174624
WA
Other
Enumeration date
02/27/2018
Last updated
04/04/2025
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