Provider Demographics
NPI:1447392063
Name:CLARAVALL, VICTORIA ESCOBAR (CSW)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ESCOBAR
Last Name:CLARAVALL
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:MS
Other - First Name:VIQUI
Other - Middle Name:ESCOBAR
Other - Last Name:CLARAVALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, LICSW
Mailing Address - Street 1:2366 EASTLAKE AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3366
Mailing Address - Country:US
Mailing Address - Phone:206-819-9024
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:AREIS BUILDING SUITE 216
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-819-9024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000049761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA800013126OtherRAILROAD MEDICARE
P56879Medicare UPIN
WAAB28476Medicare ID - Type UnspecifiedUW PHYSICIANS