Provider Demographics
NPI:1447722012
Name:SUMPTION, CAREN GUSSOFF (CPC, CVA, AAC, MFA)
Entity type:Individual
Prefix:
First Name:CAREN
Middle Name:GUSSOFF
Last Name:SUMPTION
Suffix:
Gender:F
Credentials:CPC, CVA, AAC, MFA
Other - Prefix:
Other - First Name:CAREN
Other - Middle Name:JUDITH
Other - Last Name:GUSSOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:216 JAMES ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-5102
Mailing Address - Country:US
Mailing Address - Phone:206-464-6454
Mailing Address - Fax:
Practice Address - Street 1:216 JAMES ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-5102
Practice Address - Country:US
Practice Address - Phone:206-464-6454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASUMPTION175T00000X
WACG60710364171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist