Jami Larson, LICSW | |
931 S Market Blvd, Chehalis, WA 98532-3423 | |
(360) 767-6300 | |
(360) 767-6320 |
Full Name | Jami Larson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 931 S Market Blvd, Chehalis, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215084280 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LW00009201 (Washington) | Primary |
Entity Name | Providence Health & Services Washington |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174744304 PECOS PAC ID: 6709782600 Enrollment ID: O20031211000028 |
Mailing Address | Practice Location Address |
---|---|
Jami Larson, LICSW 931 S Market Blvd, Chehalis, WA 98532-3423 Ph: (360) 767-6300 | Jami Larson, LICSW 931 S Market Blvd, Chehalis, WA 98532-3423 Ph: (360) 767-6300 |
Mr. David Mann Nixon, LCSW, DMHP Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 2690 Ne Kresky Ave, Chehalis, WA 98532 Phone: 360-330-9595 Fax: 360-330-9560 | |
Mrs. Erica M Dennehy, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 931 S Market Blvd, Chehalis, WA 98532 Phone: 360-767-6300 | |
Jyella Deloney, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2690 Ne Kresky Ave, Chehalis, WA 98532 Phone: 360-330-9595 Fax: 360-330-7865 |