Provider Demographics
NPI:1245372838
Name:DAUTOFF, STUART L (MSW)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:L
Last Name:DAUTOFF
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 E MADISON ST # 306
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4214
Mailing Address - Country:US
Mailing Address - Phone:206-860-2645
Mailing Address - Fax:206-860-2411
Practice Address - Street 1:2910 E MADISON ST # 306
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4214
Practice Address - Country:US
Practice Address - Phone:206-860-2645
Practice Address - Fax:206-860-2411
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000064451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical