Individual provider Active NPI

Pamela Kay Williamson, MSW ACSW LICSW

  • Clinical Social Worker
  • North Bend, WA
National Provider Identifier
1528112059
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW0004749 Issued in WA
Practice address
530 Ogle Ave NE
North Bend, WA 98045
Phone
(425) 831-5371
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

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 LW0004749 WA Primary

Addresses

Primary practice location

530 Ogle Ave NE
North Bend, WA 98045

Mailing address

530 Ogle Ave NE
North Bend, WA 98045
Phone (425) 831-5371

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 5, 2024 through Feb 5, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LW0004749WAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528112059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 OGLE AVE NE",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "98045",
            "telephone_number": "425-831-5371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 OGLE AVE NE",
            "city": "NORTH BEND",
            "state": "WA",
            "postal_code": "98045",
            "telephone_number": "425-831-5371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "PAMELA",
        "middle_name": "KAY",
        "name_prefix": "Ms.",
        "credential": "MSW ACSW LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW0004749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bend, WA

Sources for this page

Verify at the official NPI Registry.