Provider Demographics
NPI:1487198149
Name:NGUYEN, TRINH (LICSW)
Entity Type:Individual
Prefix:
First Name:TRINH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1236 S JACKSON ST
Mailing Address - Street 2:SUITE #C
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2045
Mailing Address - Country:US
Mailing Address - Phone:206-302-9134
Mailing Address - Fax:
Practice Address - Street 1:1236 S JACKSON ST
Practice Address - Street 2:SUITE #C
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2045
Practice Address - Country:US
Practice Address - Phone:206-302-9134
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW606826361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical