Provider Demographics
NPI:1063717999
Name:EASTER, COREEN MARGARET (MSW, ACSW, LICSW)
Entity type:Individual
Prefix:MS
First Name:COREEN
Middle Name:MARGARET
Last Name:EASTER
Suffix:
Gender:F
Credentials:MSW, ACSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6744 64TH CT SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98513-4123
Mailing Address - Country:US
Mailing Address - Phone:360-584-7521
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-4123
Practice Address - Country:US
Practice Address - Phone:253-968-3066
Practice Address - Fax:253-968-0384
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-25
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS184011041C0700X
WALW601274141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical