Provider Demographics
NPI:1255586814
Name:BURNISON, MONICA JO (MSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:JO
Last Name:BURNISON
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 1:2225 4TH AVE
Mailing Address - Street 2:THE MEZZANINE
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2000
Mailing Address - Country:US
Mailing Address - Phone:206-229-7640
Mailing Address - Fax:
Practice Address - Street 1:401 5TH AVE STE 400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2377
Practice Address - Country:US
Practice Address - Phone:206-263-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60125059104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker