Provider Demographics
NPI:1902529449
Name:FLOURNOY-EARNSHAW, KRISTIE (LSWAIC)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:FLOURNOY-EARNSHAW
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:KRISTIE
Other - Middle Name:
Other - Last Name:FLOURNOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11633 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-3945
Mailing Address - Country:US
Mailing Address - Phone:253-495-5776
Mailing Address - Fax:
Practice Address - Street 1:506 2ND AVE STE 1400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2329
Practice Address - Country:US
Practice Address - Phone:425-626-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613112151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical