NPI 1366804049 · live from the CMS NPI Registry
Tracey Alta, LICSW
Social Worker, Clinical in Seattle, WA. National Provider Identifier 1366804049, active.
NPI record
| NPI | 1366804049 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 4540 Union Bay Pl Ne, Seattle, WA 98105 |
| Practice phone | 206-320-4025 |
| Mailing address | 3616 Interlake Ave N, Seattle, WA 98103 |
| Enumerated | March 22, 2016 |
| Last updated | March 17, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker | 104100000X | LW00009543 (WA) |
| Social Worker, Clinical primary | 1041C0700X | LW00009543 (WA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.