Provider Demographics
NPI:1992414205
Name:GONZALEZ, RACHEL MARIE (MSW, LSWAIC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:MARIE
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSW, LSWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14915 SE 177TH PL APT 22R
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98058-9073
Mailing Address - Country:US
Mailing Address - Phone:425-728-9734
Mailing Address - Fax:
Practice Address - Street 1:14915 SE 177TH PL APT 22R
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98058-9073
Practice Address - Country:US
Practice Address - Phone:425-728-9734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-16
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC609140871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical