Jaeren Anthony Davis, LICSW, QMHP-C is a medicare enrolled "Social Worker - Clinical" provider in Vancouver, Washington. His current practice location is
400 Ne Mother Joseph Pl, Vancouver, Washington. You can reach out to his office (for appointments etc.) via phone at
(360) 256-2000.
Jaeren Anthony Davis is licensed to practice in Washington (license number LW61031767) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386047884.
Healthcare Provider's Profile
Full Name | Jaeren Anthony Davis |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 400 Ne Mother Joseph Pl, Vancouver, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1386047884
- Provider Enumeration Date: 09/29/2014
- Last Update Date: 01/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042663635
- Enrollment ID: I20240131000433
Medical Identifiers
Medical identifiers for Jaeren Anthony Davis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1386047884 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101Y00000X | Counselor | THW00071 (Oregon) | Secondary |
1041C0700X | Social Worker - Clinical | LW61031767 (Washington) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jaeren Anthony Davis allows following entities to bill medicare on his behalf.
Entity Name | Peacehealth |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134178999 PECOS PAC ID: 9739092065 Enrollment ID: O20031111000831 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jaeren Anthony Davis is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jaeren Anthony Davis, LICSW, QMHP-C 3601 V St, Vancouver, WA 98663-2622 Ph: (503) 754-2834 | Jaeren Anthony Davis, LICSW, QMHP-C 400 Ne Mother Joseph Pl, Vancouver, WA 98664-3200 Ph: (360) 256-2000 |
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