Provider Demographics
NPI:1821804634
Name:BIRK, LIANNE CAROLINE (LSWAIC)
Entity type:Individual
Prefix:
First Name:LIANNE
Middle Name:CAROLINE
Last Name:BIRK
Suffix:
Gender:
Credentials:LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 10TH AVE E APT 102
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-4558
Mailing Address - Country:US
Mailing Address - Phone:206-335-1814
Mailing Address - Fax:
Practice Address - Street 1:956 10TH AVE E APT 102
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-4558
Practice Address - Country:US
Practice Address - Phone:206-335-1814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-06
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC615782771041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical