Provider Demographics
NPI:1790463248
Name:WHITTAKER, ZOFIA MAE (MSW, LICSWA)
Entity Type:Individual
Prefix:
First Name:ZOFIA
Middle Name:MAE
Last Name:WHITTAKER
Suffix:
Gender:F
Credentials:MSW, LICSWA
Other - Prefix:
Other - First Name:ZOSIA
Other - Middle Name:
Other - Last Name:WHITTAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16150 NE 85TH ST STE 222B
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-3546
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST STE 222B
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3546
Practice Address - Country:US
Practice Address - Phone:425-549-4620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC614429071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical