Basic Information
| Provider Information | |||||||||
| NPI: | 1417461039 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STEINHAUS | ||||||||
| FirstName: | RANDY | ||||||||
| MiddleName: | MARTIN | ||||||||
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| Credential: | LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5316 RAINIER AVE S | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981182354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5092417938 | ||||||||
| FaxNumber: | 2063263825 | ||||||||
| Practice Location | |||||||||
| Address1: | 5316 RAINIER AVE S | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981182354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067215600 | ||||||||
| FaxNumber: | 2063263825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/17/2017 | ||||||||
| LastUpdateDate: | 06/10/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/10/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LW60488168 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.