Provider Demographics
NPI:1912442294
Name:BREWSTER, STUART ALAN (LICSW)
Entity Type:Individual
Prefix:
First Name:STUART
Middle Name:ALAN
Last Name:BREWSTER
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 15TH AVE S STE 103
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1874
Mailing Address - Country:US
Mailing Address - Phone:360-229-5758
Mailing Address - Fax:360-229-5762
Practice Address - Street 1:4501 15TH AVE S STE 103
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1874
Practice Address - Country:US
Practice Address - Phone:360-229-5758
Practice Address - Fax:360-229-5762
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW606860771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical