Provider Demographics
NPI:1225172711
Name:FINESILVER-QUINN, VICKI L (SW)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:L
Last Name:FINESILVER-QUINN
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13741 148TH PL. SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059
Mailing Address - Country:US
Mailing Address - Phone:425-235-2807
Mailing Address - Fax:425-235-4572
Practice Address - Street 1:13741 148TH PL. SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059
Practice Address - Country:US
Practice Address - Phone:425-235-2807
Practice Address - Fax:425-235-4572
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004693104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAS56588Medicare UPIN