Provider Demographics
NPI:1417735531
Name:ANDERSON, NATALIE JEAN (MSW, LICSW)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:JEAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:MISS
Other - First Name:NATALIE
Other - Middle Name:JEAN
Other - Last Name:BLACKSTONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:1202 TERRY AVE RM 210
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2745
Mailing Address - Country:US
Mailing Address - Phone:206-471-8184
Mailing Address - Fax:
Practice Address - Street 1:925 SENECA ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2742
Practice Address - Country:US
Practice Address - Phone:206-471-8184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW606324831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty