Basic Information
| Provider Information | |||||||||
| NPI: | 1417135146 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LATHROP-SKALOS | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | CAMPBELL | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | LCSW, LICSW, BCD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15811 AMBAUM BLVD SW STE 110 | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062428211 | ||||||||
| FaxNumber: | 2062420162 | ||||||||
| Practice Location | |||||||||
| Address1: | 15811 AMBAUM BLVD SW STE 110 | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981663071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062428211 | ||||||||
| FaxNumber: | 2062420162 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2008 | ||||||||
| LastUpdateDate: | 03/18/2019 | ||||||||
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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 | 38131 | ID | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 60870468 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 3264 | LA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.