Provider Demographics
NPI:1659351286
Name:KAUFMAN, RONNIE E (LICSW)
Entity Type:Individual
Prefix:MS
First Name:RONNIE
Middle Name:E
Last Name:KAUFMAN
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 1:16040 CHRISTENSEN RD
Mailing Address - Street 2:STE 212
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2966
Mailing Address - Country:US
Mailing Address - Phone:206-431-5336
Mailing Address - Fax:206-431-5430
Practice Address - Street 1:16040 CHRISTENSEN RD
Practice Address - Street 2:STE 212
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2966
Practice Address - Country:US
Practice Address - Phone:206-431-5336
Practice Address - Fax:206-431-5430
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000050891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical