Provider Demographics
NPI:1932456902
Name:WILLER, DENISE RIBEIRA
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:RIBEIRA
Last Name:WILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4515 MARTIN LUTHER KING JR WAY S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-2182
Mailing Address - Country:US
Mailing Address - Phone:206-923-3940
Mailing Address - Fax:206-923-3904
Practice Address - Street 1:4515 MARTIN LUTHER KING JR WAY S
Practice Address - Street 2:SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-2182
Practice Address - Country:US
Practice Address - Phone:206-923-3940
Practice Address - Fax:206-923-3904
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker