| Jami Larson, LICSW | |
|
931 S Market Blvd, Chehalis, WA 98532-3423 | |
| (360) 767-6300 | |
| (360) 767-6320 |
| Full Name | Jami Larson |
|---|---|
| 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 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174744304 PECOS PAC ID: 6709782600 Enrollment ID: O20031211000028 |
| Entity Name | Providence Health & Services - Washington |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1205931508 PECOS PAC ID: 2365427556 Enrollment ID: O20040622000640 |
| 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: Not Enrolled in Medicare 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: Not Enrolled in Medicare 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 | |
Anthony Curtis Shaw, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 151 Ne Hampe Way, Chehalis, WA 98532 Phone: 360-345-6790 |