Ralph Kieffer Quillman, ACSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00006531 Issued in WA

Practice address

1814 105TH St SE
Everett, WA 98208

Phone

(425) 385-8118

Fax

(425) 385-3748

NPI assigned

Nov 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1124191101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1814 105TH ST SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-385-8118",
            "fax_number": "425-385-3748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 105TH ST SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-385-8118",
            "fax_number": "425-385-3748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUILLMAN",
        "first_name": "RALPH",
        "middle_name": "KIEFFER",
        "credential": "ACSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikaella Rose Quiba, LICSW
• June Brooks Quick, PT
• Samina Quidwai
• Jason Quigley
• Kameon Gwin Quillen, M.A.
• Gimmy Quindiagan
• Allison Quinn
• Peter Quinn
• Joshua Alexander Quinto, PHARMD
• Gabriela Camilla Quiroz, DNP

• Clinical Social Worker in Everett, WA
• Providers in Everett, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.