Provider Demographics
NPI:1376990721
Name:WELLER, MARIANA LEIGH (MSW)
Entity Type:Individual
Prefix:
First Name:MARIANA
Middle Name:LEIGH
Last Name:WELLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:MARIANA
Other - Middle Name:LEIGH
Other - Last Name:GRALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:1600 E OLIVE ST
Practice Address - Street 2:SOUND MENTAL HEALTH
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2735
Practice Address - Country:US
Practice Address - Phone:206-302-2200
Practice Address - Fax:206-302-2210
Is Sole Proprietor?:No
Enumeration Date:2016-05-16
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASA 606406711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical