Provider Demographics
NPI:1861628737
Name:RIVERA, ANA MARIE SISON (MSW)
Entity Type:Individual
Prefix:MS
First Name:ANA MARIE
Middle Name:SISON
Last Name:RIVERA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:SISON
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:9854 30TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-4111
Mailing Address - Country:US
Mailing Address - Phone:206-935-6261
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC000375351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical