Provider Demographics
NPI:1255774931
Name:TIMOTHY J KAHN MSW
Entity type:Organization
Organization Name:TIMOTHY J KAHN MSW
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:425-462-9647
Mailing Address - Street 1:11747 NE 1ST ST
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3053
Mailing Address - Country:US
Mailing Address - Phone:425-462-9647
Mailing Address - Fax:425-462-9333
Practice Address - Street 1:11747 NE 1ST ST
Practice Address - Street 2:SUITE 330
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3053
Practice Address - Country:US
Practice Address - Phone:425-462-9647
Practice Address - Fax:425-462-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-11
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 000051411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty