Provider Demographics
NPI:1174280887
Name:UDDIN, HAFSA (LSWAIC)
Entity Type:Individual
Prefix:
First Name:HAFSA
Middle Name:
Last Name:UDDIN
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 N 105TH ST UNIT 302
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9299
Mailing Address - Country:US
Mailing Address - Phone:305-721-9093
Mailing Address - Fax:
Practice Address - Street 1:555 N 105TH ST UNIT 302
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9299
Practice Address - Country:US
Practice Address - Phone:305-721-9093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC611762681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty