Provider Demographics
NPI:1184854374
Name:SELLE, SHARON FARBER (MSW)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:FARBER
Last Name:SELLE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX 356125
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6125
Mailing Address - Country:US
Mailing Address - Phone:206-598-4222
Mailing Address - Fax:206-598-6333
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 356125
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6125
Practice Address - Country:US
Practice Address - Phone:206-598-4222
Practice Address - Fax:206-598-6333
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00005965104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker