Basic Information
| Provider Information | |||||||||
| NPI: | 1467121145 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALAZAR | ||||||||
| FirstName: | KIRSTEN | ||||||||
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| Credential: | MSW, LSWAIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5903 S EASTWOOD DR | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981782436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7199373943 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1210 SW 136TH ST | ||||||||
| Address2: | |||||||||
| City: | BURIEN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981661214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062576600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2021 | ||||||||
| LastUpdateDate: | 09/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 61201141 | WA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.