Provider Demographics
NPI:1083285019
Name:FARROW, MIRA (MA, MSW, LSWAIC)
Entity Type:Individual
Prefix:MISS
First Name:MIRA
Middle Name:
Last Name:FARROW
Suffix:
Gender:F
Credentials:MA, MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 S LANE ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2810
Mailing Address - Country:US
Mailing Address - Phone:206-441-3329
Mailing Address - Fax:206-441-3014
Practice Address - Street 1:520 2ND AVE W APT 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3977
Practice Address - Country:US
Practice Address - Phone:206-210-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-09
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical