Basic Information
Provider Information
NPI: 1073783403
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HIRAI-SEATON
FirstName: TRACY
MiddleName: A.
NamePrefix:  
NameSuffix:  
Credential: MSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HIRAI
OtherFirstName: TRACY
OtherMiddleName: A.
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 24366
Address2:  
City: SEATTLE
State: WA
PostalCode: 981240366
CountryCode: US
TelephoneNumber: 2065980502
FaxNumber: 2065980516
Practice Location
Address1: 1959 NE PACIFIC ST
Address2:  
City: SEATTLE
State: WA
PostalCode: 981950001
CountryCode: US
TelephoneNumber: 2065985134
FaxNumber: 2065986333
Other Information
ProviderEnumerationDate: 02/29/2008
LastUpdateDate: 02/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XLW00008215WAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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