Provider Demographics
NPI:1124645445
Name:MORETZ, CAITLIN (LSWAA)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:
Last Name:MORETZ
Suffix:
Gender:F
Credentials:LSWAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 NW LEARY WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5138
Mailing Address - Country:US
Mailing Address - Phone:253-470-8154
Mailing Address - Fax:
Practice Address - Street 1:1417 NW 54TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3570
Practice Address - Country:US
Practice Address - Phone:253-470-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA64036137111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical