Individual provider Active NPI

Christian Isaac Quintanar

  • Clinical Social Worker
  • Tukwila, WA
National Provider Identifier
1124490891
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128493 Issued in CA
Practice address
3438 S 148TH St
Tukwila, WA 98168-4319
Phone
(206) 490-0865
NPI assigned
Oct 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X 128493 CA Primary

Addresses

Primary practice location

3438 S 148TH St
Tukwila, WA 98168-4319

Mailing address

3438 S 148TH St
Tukwila, WA 98168-4319
Phone (206) 490-0865

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
128493CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1124490891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3438 S 148TH ST",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981684319",
            "telephone_number": "206-490-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3438 S 148TH ST",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981684319",
            "telephone_number": "206-490-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANAR",
        "first_name": "CHRISTIAN",
        "middle_name": "ISAAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-21",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "128493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.