Provider Demographics
NPI:1962954891
Name:GROUP HEALTH
Entity type:Organization
Organization Name:GROUP HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INNOVATION SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:JENIKA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:RICHARD-WEBBER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:503-803-0899
Mailing Address - Street 1:20210 84TH PL W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-6604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9800 4TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2152
Practice Address - Country:US
Practice Address - Phone:206-302-1200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW604632461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty