Provider Demographics
NPI:1992700645
Name:DICKMAN, DAVID E (MSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:E
Last Name:DICKMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33600 6TH AVE S
Mailing Address - Street 2:STE 212
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6743
Mailing Address - Country:US
Mailing Address - Phone:253-661-0181
Mailing Address - Fax:
Practice Address - Street 1:33600 6TH AVE S
Practice Address - Street 2:STE 212
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6743
Practice Address - Country:US
Practice Address - Phone:253-661-0181
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000049611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical