| Emily Landis Licsw Pllc | |
|
113 S Eunice St Port Angeles WA 98362-3333 | |
| (360) 477-5668 | |
| Not Available |
| Full Name | Emily Landis Licsw Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 113 S Eunice St, Port Angeles, Washington |
| Authorized Official Name and Position | Emily J Landis (OWNER) |
| Authorized Official Contact | 3604775668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Emily Landis Licsw Pllc Po Box 2223 Port Angeles WA 98362-0289 Ph: (360) 477-5668 | Emily Landis Licsw Pllc 113 S Eunice St Port Angeles WA 98362-3333 Ph: (360) 477-5668 |
| NPI Number | 1629589866 |
|---|---|
| Provider Enumeration Date | 10/16/2017 |
| Last Update Date | 10/16/2017 |
| Medicare PECOS PAC ID | 3870859580 |
|---|---|
| Medicare Enrollment ID | O20171114000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629589866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LW60524212 (Washington) | Primary |
| Provider Name | Emily Jean Last |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114048873 PECOS PAC ID: 8729135199 Enrollment ID: I20150225002478 |
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