Provider Demographics
NPI:1467121145
Name:SALAZAR, KIRSTEN (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3788 NE 4TH ST APT E104
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-8468
Mailing Address - Country:US
Mailing Address - Phone:719-937-3943
Mailing Address - Fax:
Practice Address - Street 1:2100 24TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4637
Practice Address - Country:US
Practice Address - Phone:206-382-5340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-07
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW615331311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical