Provider Demographics
NPI:1699172395
Name:STELLER, FIEVEL JACK (MSW)
Entity type:Individual
Prefix:
First Name:FIEVEL
Middle Name:JACK
Last Name:STELLER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:FIEVEL
Other - Middle Name:JACK
Other - Last Name:FINLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4060 EAST STEVENS WAY N HALL HEALTH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-4410
Mailing Address - Country:US
Mailing Address - Phone:206-543-8606
Mailing Address - Fax:
Practice Address - Street 1:4060 E STEVENS WAY NE HALL HEALTH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-4410
Practice Address - Country:US
Practice Address - Phone:206-543-8606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-24
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW607461411041C0700X
WACO60468596390200000X
WASC604855681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program