Individual provider Active NPI

Stuart L Dautoff, M.S.W.

  • Clinical Social Worker
  • Seattle, WA
National Provider Identifier
1245372838
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00006445 Issued in WA
Practice address
2910 E Madison St # 306
Seattle, WA 98112-4214
Phone
(206) 860-2645
Fax
(206) 860-2411
NPI assigned
Feb 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LW00006445 WA Primary

Addresses

Primary practice location

2910 E Madison St # 306
Seattle, WA 98112-4214

Mailing address

2910 E Madison St # 306
Seattle, WA 98112-4214
Phone (206) 860-2645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 15, 2020 through Jun 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW00006445WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245372838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 E MADISON ST # 306",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124214",
            "telephone_number": "206-860-2645",
            "fax_number": "206-860-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 E MADISON ST # 306",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981124214",
            "telephone_number": "206-860-2645",
            "fax_number": "206-860-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUTOFF",
        "first_name": "STUART",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00006445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.