Basic Information
| Provider Information | |||||||||
| NPI: | 1114218476 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAKEUCHI | ||||||||
| FirstName: | RIE | ||||||||
| MiddleName: | TSUEI | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MSW, LICSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2019 NE 33RD PL | ||||||||
| Address2: | |||||||||
| City: | RENTON | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980568004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067784994 | ||||||||
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| Practice Location | |||||||||
| Address1: | 10200 NE 132ND ST | ||||||||
| Address2: | |||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980342831 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258212000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/21/2011 | ||||||||
| LastUpdateDate: | 12/20/2012 | ||||||||
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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 | I.1000372 | OH | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | 6801092842 | MI | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 1041C0700X | LW60305822 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.