Provider Demographics
NPI:1043616659
Name:AGING STEWARDSHIP LLC
Entity Type:Organization
Organization Name:AGING STEWARDSHIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JUTTA
Authorized Official - Middle Name:E
Authorized Official - Last Name:ATAIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LICSW
Authorized Official - Phone:206-941-3851
Mailing Address - Street 1:13123 SW 196TH ST
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-4805
Mailing Address - Country:US
Mailing Address - Phone:206-941-3851
Mailing Address - Fax:
Practice Address - Street 1:18017 VASHON HWY SW
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-5205
Practice Address - Country:US
Practice Address - Phone:206-941-3851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 601528751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty