| Epic Possibilities And Development | |
|
204 Custer Way Sw Ste 101 Tumwater WA 98501-3330 | |
| (360) 480-5388 | |
| Not Available |
| Full Name | Epic Possibilities And Development |
|---|---|
| Speciality | Social Worker |
| Location | 204 Custer Way Sw Ste 101, Tumwater, Washington |
| Authorized Official Name and Position | Lauren Mallory (OWNER) |
| Authorized Official Contact | 3604805388 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Epic Possibilities And Development 204 Custer Way Sw Ste 101 Tumwater WA 98501-3330 Ph: (360) 480-5388 | Epic Possibilities And Development 204 Custer Way Sw Ste 101 Tumwater WA 98501-3330 Ph: (360) 480-5388 |
| NPI Number | 1881295566 |
|---|---|
| Provider Enumeration Date | 11/08/2020 |
| Last Update Date | 01/26/2026 |
| Certification Date | 01/26/2026 |
| Medicare PECOS PAC ID | 5890102016 |
|---|---|
| Medicare Enrollment ID | O20210405001798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881295566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Denise M Haselwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548727324 PECOS PAC ID: 5092057216 Enrollment ID: I20190508001161 |
| Provider Name | Lauren Louise Mallory |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003265257 PECOS PAC ID: 9032539689 Enrollment ID: I20250106000193 |
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