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NPI Code Detail

MEDICARE: RAYMARK LAYDA MORALES MSW, LICSW

MEDICARE: RAYMARK LAYDA MORALES MSW, LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
21041C0700XClinical Social WorkerLW61272426WA

General Provider Information

NPI Number : 1386231793
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMARK LAYDA MORALES MSW, LICSW
Provider Business Mailing Address
First Line : 3857 MARTIN WAY E
Second Line :
City : OLYMPIA
State : WA
Zip : 98506-5268
Country : US
Telephone Number : 360-704-7170
Fax Number :
Provider Business Practice Location Address
First Line : 500 COLUMBIA ST NW STE 102
Second Line :
City : OLYMPIA
State : WA
Zip : 98501-4447
Country : US
Telephone Number : 253-752-7320
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2020
Last Update Date : 04/07/2023

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