Provider Demographics
NPI:1114104379
Name:OZRETICH, BART THOMAS (MSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:BART
Middle Name:THOMAS
Last Name:OZRETICH
Suffix:
Gender:M
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 E DENNY WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-3126
Mailing Address - Country:US
Mailing Address - Phone:206-769-5685
Mailing Address - Fax:844-787-9886
Practice Address - Street 1:5425 RAINIER AVE S STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2455
Practice Address - Country:US
Practice Address - Phone:650-336-5384
Practice Address - Fax:844-787-9886
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000093701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical