Provider Demographics
NPI:1982840476
Name:SPRINGER, VICKI MARIE (MSW)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:MARIE
Last Name:SPRINGER
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 1:3020 RUCKER AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3900
Mailing Address - Country:US
Mailing Address - Phone:425-339-8664
Mailing Address - Fax:425-339-5255
Practice Address - Street 1:3020 RUCKER AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3900
Practice Address - Country:US
Practice Address - Phone:425-339-8664
Practice Address - Fax:425-339-5255
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-05
Last Update Date:2009-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC 00004370104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC 00004370OtherWASHINGTON STATE DEPARTMENT OF HEALTH