Provider Demographics
NPI:1992396105
Name:HEIDENREICH, RACHEL ANNE (MSW, LSWAIC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANNE
Last Name:HEIDENREICH
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18406 215TH WAY NE
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98077-7161
Mailing Address - Country:US
Mailing Address - Phone:425-773-4918
Mailing Address - Fax:
Practice Address - Street 1:13901 NE 175TH ST
Practice Address - Street 2:STE. C
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:425-773-4918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-30
Last Update Date:2021-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC611013111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical