Mariam Ross, LW60276157
Individual provider Active NPI Clinical Social Worker · Clinton, WA
NPI 1962555656 · NPPES record last updated Jul 1, 2014
Key facts
- NPI
- 1962555656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LW60276157 (WA)
- Practice address
- 11245 State Route 525
Clinton, WA 98236-8638 - Phone
- (360) 341-5252
- Fax
- (360) 341-8727
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60276157 | WA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LW60276157 | WA | Yes |
Addresses
Primary practice location
11245 State Route 525
Clinton, WA 98236-8638
Mailing address
PO Box 3603
Seattle, WA 98124-3603
Phone (360) 341-5252
Other providers in Clinton, WA
- Pillar Physical Therapy LLC
- Henrietta Pinkens
- June Elizabeth Polasek
- Gail Ptacek
- Billie Risa-Draves
- Kimberly Rossi
- Salish Sea Physical Therapy LLC
- Dennis Sayles
- Barbara Schiltz
- Lia B Schmitz
All providers in Clinton, WA · Clinical Social Worker in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 1, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.