Provider Demographics
NPI:1912215914
Name:LIERLE, DEAN (LICSW)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:LIERLE
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 COSGROVE ST NW
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2758
Mailing Address - Country:US
Mailing Address - Phone:206-780-2900
Mailing Address - Fax:206-842-9867
Practice Address - Street 1:793 ERICKSEN AVE NE STE 123
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1877
Practice Address - Country:US
Practice Address - Phone:206-551-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600034921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical