Basic Information
| Provider Information | |||||||||
| NPI: | 1659494227 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MACAULAY | ||||||||
| FirstName: | CAROL | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | B.C.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 303 23RD AVE S | ||||||||
| Address2: | #605 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981442377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2068603135 | ||||||||
| FaxNumber: | |||||||||
| 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: | 04/09/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | RC00042883 | WA | X | Behavioral Health & Social Service Providers | Counselor | Mental Health | 376K00000X | NA00189572 | WA | X | Nursing Service Related Providers | Nurse's Aide |
No ID Information.