Provider Demographics
NPI:1538837000
Name:QUIGGLE, DYLAN WARD BINH (MSW LICSWA MHP CMHS)
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:WARD BINH
Last Name:QUIGGLE
Suffix:
Gender:M
Credentials:MSW LICSWA MHP CMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 NE 97TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2042
Mailing Address - Country:US
Mailing Address - Phone:206-569-8392
Mailing Address - Fax:
Practice Address - Street 1:320 NE 97TH ST STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2042
Practice Address - Country:US
Practice Address - Phone:206-569-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613129111041C0700X
101Y00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No104100000XBehavioral Health & Social Service ProvidersSocial Worker