Provider Demographics
NPI:1770956013
Name:BISHOP, COLLETTE NICOLE (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:COLLETTE
Middle Name:NICOLE
Last Name:BISHOP
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7919 31ST ST W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-3303
Mailing Address - Country:US
Mailing Address - Phone:206-949-9805
Mailing Address - Fax:
Practice Address - Street 1:614 W MCGRAW ST STE 201
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3073
Practice Address - Country:US
Practice Address - Phone:206-949-9805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-09
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605891331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical