Provider Demographics
NPI:1972040012
Name:TRASK, BETHEL (MSW)
Entity Type:Individual
Prefix:
First Name:BETHEL
Middle Name:
Last Name:TRASK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 MERIDIAN AVE. N.
Mailing Address - Street 2:SUITE G-11
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9509
Mailing Address - Country:US
Mailing Address - Phone:206-461-4544
Mailing Address - Fax:206-461-6939
Practice Address - Street 1:10700 MERIDIAN AVE. N.
Practice Address - Street 2:SUITE G-11
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9509
Practice Address - Country:US
Practice Address - Phone:206-461-4544
Practice Address - Fax:206-461-6939
Is Sole Proprietor?:No
Enumeration Date:2017-01-27
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60628724104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker