1144362369 NPI number — MRS. CHARLOTTE RUTH SVENSON MSW ACSW

Table of content: MRS. CHARLOTTE RUTH SVENSON MSW ACSW (NPI 1144362369)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144362369 NPI number — MRS. CHARLOTTE RUTH SVENSON MSW ACSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SVENSON
Provider First Name:
CHARLOTTE
Provider Middle Name:
RUTH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW ACSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DORFSMAN
Provider Other First Name:
CHARLOTTE
Provider Other Middle Name:
RUTH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW ACSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144362369
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 116TH AVE NE
Provider Second Line Business Mailing Address:
#104
Provider Business Mailing Address City Name:
BELLEVUE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-453-2826
Provider Business Mailing Address Fax Number:
425-453-2818

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 116TH AVE NE
Provider Second Line Business Practice Location Address:
#104
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98004
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-453-2826
Provider Business Practice Location Address Fax Number:
425-453-2818
Provider Enumeration Date:
02/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LW00006012 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: LF00000876 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)