Provider Demographics
NPI:1366630899
Name:GRAHAM, CARA V (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:CARA
Middle Name:V
Last Name:GRAHAM
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:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0004
Mailing Address - Country:US
Mailing Address - Phone:206-484-5791
Mailing Address - Fax:425-295-7637
Practice Address - Street 1:1700 NW GILMAN BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5364
Practice Address - Country:US
Practice Address - Phone:425-922-0305
Practice Address - Fax:425-295-7637
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600405311041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical