Provider Demographics
NPI:1730304486
Name:RASMUSSEN, VERONICA D (LICSW)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:D
Last Name:RASMUSSEN
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 1:16256 MILITARY RD S STE 202
Mailing Address - Street 2:
Mailing Address - City:SEATAC
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3049
Mailing Address - Country:US
Mailing Address - Phone:206-762-3007
Mailing Address - Fax:206-243-9583
Practice Address - Street 1:16256 MILITARY RD S STE 202
Practice Address - Street 2:
Practice Address - City:SEATAC
Practice Address - State:WA
Practice Address - Zip Code:98188-3049
Practice Address - Country:US
Practice Address - Phone:206-762-3007
Practice Address - Fax:206-243-9583
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000076481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical