Individual provider Active NPI

Jongwon Seo

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1417328998
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61131905 Issued in WA
Practice address
3200 NE 109TH Ave
Vancouver, WA 98682
Phone
(360) 609-1660
Fax
(360) 695-1014
NPI assigned
Oct 9, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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 LW61131905 WA Primary

Addresses

Primary practice location

3200 NE 109TH Ave
Vancouver, WA 98682

Mailing address

10801 SE 23Rd Cir
Vancouver, WA 98664-5330
Phone (971) 713-9218

Other practice location 1

825 NE 20th Ave Ste 250
Portland, OR 97232-2282
Phone (971) 713-9218

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
LW61131905WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Family Solutions, Inc CurrentSince Mar 26, 2023 Accepting new patients

Locations

1014 Main St
Vancouver, WA 98660
Phone (360) 695-1014

3200 NE 109th Ave
Vancouver, WA 98682
Phone (360) 695-1014

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/family-solutions/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1417328998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10801 SE 23RD CIR",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986645330",
            "telephone_number": "971-713-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 NE 109TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98682",
            "telephone_number": "360-609-1660",
            "fax_number": "360-695-1014"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 NE 20th Ave Ste 250",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972322282",
            "country_code": "US",
            "telephone_number": "971-713-9218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEO",
        "first_name": "JONGWON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-09",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61131905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.