Provider Demographics
NPI:1396904009
Name:CASE, STAN E (MSW PHD)
Entity type:Individual
Prefix:DR
First Name:STAN
Middle Name:E
Last Name:CASE
Suffix:
Gender:M
Credentials:MSW PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7500 212TH ST SW
Mailing Address - Street 2:STE. #105
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7641
Mailing Address - Country:US
Mailing Address - Phone:425-775-5678
Mailing Address - Fax:
Practice Address - Street 1:7500 212TH ST SW
Practice Address - Street 2:STE #105
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7641
Practice Address - Country:US
Practice Address - Phone:425-775-5678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000061131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical