Provider Demographics
NPI:1699166256
Name:HUYNH, ELIZABETH (LICSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 S 333RD ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-7099
Mailing Address - Country:US
Mailing Address - Phone:808-387-7989
Mailing Address - Fax:
Practice Address - Street 1:402 S 333RD ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-7099
Practice Address - Country:US
Practice Address - Phone:808-387-7989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-18
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34007959A1041C0700X
WALW606554111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical