Basic Information
| Provider Information | |||||||||
| NPI: | 1003291659 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STRONG | ||||||||
| FirstName: | JUDITH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 15TH AVE E | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981125103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092417938 | ||||||||
| FaxNumber: | 2063262785 | ||||||||
| Practice Location | |||||||||
| Address1: | 2614 168TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980082234 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258996310 | ||||||||
| FaxNumber: | 4258996301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2015 | ||||||||
| LastUpdateDate: | 09/27/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LW00005866 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.