Provider Demographics
NPI:1972656775
Name:ZUCKER, LAURA ANN (MSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:ZUCKER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BROADWAY STE 170
Mailing Address - Street 2:SEATTLE WA
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5332
Mailing Address - Country:US
Mailing Address - Phone:206-302-2600
Mailing Address - Fax:206-302-2610
Practice Address - Street 1:3301 BURKE AVE N
Practice Address - Street 2:#200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9054
Practice Address - Country:US
Practice Address - Phone:206-414-9172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW600708471041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical