Provider Demographics
NPI:1346438405
Name:CAPORASO, DARYLL JEAN (MSW)
Entity Type:Individual
Prefix:
First Name:DARYLL
Middle Name:JEAN
Last Name:CAPORASO
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 1:16601 NE 80TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6643
Mailing Address - Country:US
Mailing Address - Phone:425-922-6192
Mailing Address - Fax:425-882-1313
Practice Address - Street 1:16601 NE 80TH ST
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6643
Practice Address - Country:US
Practice Address - Phone:425-922-6192
Practice Address - Fax:425-882-1313
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-13
Last Update Date:2007-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000053631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical