Individual provider Active NPI

Dale Ray Hartman, M.S.W.

  • Clinical Social Worker
  • Bellevue, WA
National Provider Identifier
1316079361
Registry record updated Jan 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW4694 Issued in WA
Practice address
11808 Northup Way
Ste W150
Bellevue, WA 98005-1936
Phone
(425) 889-1240
Fax
(425) 889-1249
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2014

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 LW4694 WA Primary

Addresses

Primary practice location

11808 Northup Way
Ste W150
Bellevue, WA 98005-1936

Mailing address

11808 Northup Way
Ste W150
Bellevue, WA 98005-1936
Phone (425) 889-1240

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
LW4694WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389312000000",
    "number": "1316079361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11808 NORTHUP WAY",
            "address_2": "STE W150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051936",
            "telephone_number": "425-889-1240",
            "fax_number": "425-889-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11808 NORTHUP WAY",
            "address_2": "STE W150",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051936",
            "telephone_number": "425-889-1240",
            "fax_number": "425-889-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "DALE",
        "middle_name": "RAY",
        "credential": "M.S.W.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2014-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW4694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; 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.