NPIMap

Individual provider Active NPI

Santiago Iscoa, MSW

  • Clinical Social Worker
  • Everett, WA
National Provider Identifier
1013294503
Registry record updated Nov 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CG 60149865 Issued in WA
Practice address
3000 Rockefeller Ave
Everett, WA 98201-4046
Phone
(425) 388-7219
Fax
(425) 388-7216
NPI assigned
Nov 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CG 60149865 WA Primary

Addresses

Primary practice location

3000 Rockefeller Ave
Everett, WA 98201-4046

Mailing address

3000 Rockefeller Ave
Everett, WA 98201-4046
Phone (425) 388-7219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CG 60149865WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Snohomish County Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1013294503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 ROCKEFELLER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014046",
            "telephone_number": "425-388-7219",
            "fax_number": "425-388-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 ROCKEFELLER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014046",
            "telephone_number": "425-388-7219",
            "fax_number": "425-388-7216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISCOA",
        "first_name": "SANTIAGO",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-10",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "CG 60149865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.