Provider Demographics
NPI:1386208478
Name:AILIAN, ARMINE (MSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:ARMINE
Middle Name:
Last Name:AILIAN
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 EVERGREEN WAY STE Z154
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-3889
Mailing Address - Country:US
Mailing Address - Phone:818-636-9306
Mailing Address - Fax:
Practice Address - Street 1:9930 EVERGREEN WAY STE Z154
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-3889
Practice Address - Country:US
Practice Address - Phone:425-263-3006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC60918965104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WASC60918965OtherWASHINGTON STATE DEPARTMENT OF HEALTH