Provider Demographics
NPI:1639676695
Name:HINZO, GENNAROSE MARGARET (MSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:GENNAROSE
Middle Name:MARGARET
Last Name:HINZO
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 1:2200 RAINIER AVE S STE 201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-4642
Mailing Address - Country:US
Mailing Address - Phone:206-417-9904
Mailing Address - Fax:
Practice Address - Street 1:2200 RAINIER AVE S STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4642
Practice Address - Country:US
Practice Address - Phone:206-417-9904
Practice Address - Fax:206-260-7464
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61147421101Y00000X
CA11205-I101YA0400X
WASC61306204104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker