Provider Demographics
NPI:1073610465
Name:RAINWATER, CONSTANCE ROSARIO (CDP)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:ROSARIO
Last Name:RAINWATER
Suffix:
Gender:F
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 NE 9TH CT
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3814
Mailing Address - Country:US
Mailing Address - Phone:425-271-5552
Mailing Address - Fax:
Practice Address - Street 1:PUGET SOUND HEALTH CARE SYSTEM (MHC116)
Practice Address - Street 2:1660 S COLUMBIAN WAY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108
Practice Address - Country:US
Practice Address - Phone:206-277-3307
Practice Address - Fax:206-764-2572
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00004778101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health