Provider Demographics
NPI:1326513953
Name:SCHUNNEMAN, LARA D (MSW)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:D
Last Name:SCHUNNEMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 NE 131ST PL
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3934
Mailing Address - Country:US
Mailing Address - Phone:206-854-8793
Mailing Address - Fax:
Practice Address - Street 1:851 POPLAR PL S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2827
Practice Address - Country:US
Practice Address - Phone:206-322-2387
Practice Address - Fax:206-322-6306
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker