Provider Demographics
NPI:1134371016
Name:TERBIETEN, ALLISON MAY (BA, MSW, LICSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MAY
Last Name:TERBIETEN
Suffix:
Gender:F
Credentials:BA, MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5699
Mailing Address - Country:US
Mailing Address - Phone:206-320-7070
Mailing Address - Fax:206-320-4568
Practice Address - Street 1:550 16TH AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5699
Practice Address - Country:US
Practice Address - Phone:206-320-7070
Practice Address - Fax:206-320-4568
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 603489021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical