Basic Information
| Provider Information | |||||||||
| NPI: | 1689825390 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ISQUITH | ||||||||
| FirstName: | ABIGAIL | ||||||||
| MiddleName: | |||||||||
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| Credential: | LSWAIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 905 SPRUCE ST, STE 300 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2064616935 | ||||||||
| FaxNumber: | 2064618382 | ||||||||
| Practice Location | |||||||||
| Address1: | 1629 N 45TH | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2066333350 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/01/2008 | ||||||||
| LastUpdateDate: | 09/28/2010 | ||||||||
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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 | 1041C0700X | SC60108102 | WA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.