Individual provider Active NPI

Edin Dail Denison, LCSW, LICSW

  • Clinical Social Worker
  • Everett, WA
National Provider Identifier
1578015145
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW61446513 Issued in WA
Practice address
3327 Colby Ave
Everett, WA 98201
Phone
(360) 564-0930
NPI assigned
Oct 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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 LW61446513 WA Primary

Addresses

Primary practice location

3327 Colby Ave
Everett, WA 98201

Mailing address

PO Box 257
Olympia, WA 98507-0257
Phone (360) 564-0903

Other practice location 1

4784 N Lombard St Ste B5026
Portland, OR 97203-4565
Phone (360) 564-0903

Other practice location 2

316 W Boone Ave Ste 850
Spokane, WA 99201-2353
Phone (360) 564-0903

Other identifiers 1

IdentifierTypeStateIssuer
2224675MedicaidWA

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
LW61446513WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pend Oreille County Counseling Services Past Accepting new patients
Pend Oreille County Counseling Services Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/pendoreilleco/r4/

Organizations & group practices 2

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": "1477872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1578015145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 257",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985070257",
            "telephone_number": "360-564-0903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "360-564-0930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4784 N Lombard St Ste B5026",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972034565",
            "country_code": "US",
            "telephone_number": "360-564-0903",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "316 W Boone Ave Ste 850",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992012353",
            "country_code": "US",
            "telephone_number": "360-564-0903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DENISON",
        "first_name": "EDIN",
        "middle_name": "DAIL",
        "credential": "LCSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-31",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW61446513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2224675",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.