Provider Demographics
NPI:1366042616
Name:TAMMINEN, LIA ROSE (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:LIA
Middle Name:ROSE
Last Name:TAMMINEN
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 S JACKSON ST STE 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2872
Mailing Address - Country:US
Mailing Address - Phone:707-775-5214
Mailing Address - Fax:
Practice Address - Street 1:3801 150TH AVE SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1668
Practice Address - Country:US
Practice Address - Phone:425-460-7114
Practice Address - Fax:425-460-7115
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614595321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical