Provider Demographics
NPI:1962885236
Name:DELGADO, DAVID
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DELGADO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 19TH AVE E
Mailing Address - Street 2:APT 109
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4073
Mailing Address - Country:US
Mailing Address - Phone:646-483-3092
Mailing Address - Fax:
Practice Address - Street 1:620 19TH AVE E
Practice Address - Street 2:APT 109
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4073
Practice Address - Country:US
Practice Address - Phone:646-483-3092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker