Provider Demographics
NPI:1881728897
Name:MACQUIVEY, KAREN (LICSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:MACQUIVEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6527 21ST AVE NE # 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6947
Mailing Address - Country:US
Mailing Address - Phone:206-335-2627
Mailing Address - Fax:
Practice Address - Street 1:6527 21ST AVE NE # 4
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6947
Practice Address - Country:US
Practice Address - Phone:206-285-9168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000053651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAR94978Medicare UPIN