Basic Information
| Provider Information | |||||||||
| NPI: | 1710101522 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWEN-CRAWFORD | ||||||||
| FirstName: | T. EVELYN | ||||||||
| MiddleName: | J. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | L.I.C.S.W., C.D.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 E. OLIVE ST, | ||||||||
| Address2: | SUITE #100 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063022200 | ||||||||
| FaxNumber: | 2063022210 | ||||||||
| Practice Location | |||||||||
| Address1: | 4238 AUBURN WAY N | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980021311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538767600 | ||||||||
| FaxNumber: | 2538767610 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2007 | ||||||||
| LastUpdateDate: | 02/19/2016 | ||||||||
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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 | 101YA0400X | CP00004171 | WA | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 1041C0700X | LW60163577 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.