Provider Demographics
NPI:1861516825
Name:FEINBERG, RON K (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:RON
Middle Name:K
Last Name:FEINBERG
Suffix:
Gender:M
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 1:8015 SE 28TH ST
Mailing Address - Street 2:STE 309
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2910
Mailing Address - Country:US
Mailing Address - Phone:206-236-1294
Mailing Address - Fax:630-604-9955
Practice Address - Street 1:8015 SE 28TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-2910
Practice Address - Country:US
Practice Address - Phone:206-236-1294
Practice Address - Fax:630-604-9955
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000045611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB33967Medicare ID - Type Unspecified