Basic Information
Provider Information
NPI: 1346473055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELANEY
FirstName: LUCILE
MiddleName: SARAH
NamePrefix:  
NameSuffix:  
Credential: RC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GROSSMAN
OtherFirstName: LUCILE
OtherMiddleName: SARAH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 1600 E OLIVE ST
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981222735
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Practice Location
Address1: 1600 E OLIVE ST
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981222735
CountryCode: US
TelephoneNumber: 2063022200
FaxNumber: 2063022210
Other Information
ProviderEnumerationDate: 08/27/2009
LastUpdateDate: 08/27/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000XRC60038949WAY Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


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