Provider Demographics
NPI:1215415401
Name:SILPAKIT, NATHAN (LSWAIC)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:SILPAKIT
Suffix:
Gender:X
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3519 S 137TH ST
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3965
Mailing Address - Country:US
Mailing Address - Phone:360-359-6055
Mailing Address - Fax:
Practice Address - Street 1:3519 S 137TH ST
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3965
Practice Address - Country:US
Practice Address - Phone:360-359-6055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-31
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC61550823104100000X
WACP60923338101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2109961Medicaid