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NPI Code Detail

MEDICARE: MS. TRICIA ANN VAIL LICSW

MEDICARE: MS. TRICIA ANN VAIL 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
11041C0700XClinical Social WorkerLW60017907WA

General Provider Information

NPI Number : 1871553628
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. TRICIA ANN VAIL LICSW
Provider Business Mailing Address
First Line : 118 E 8TH ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-6129
Country : US
Telephone Number : 360-457-0431
Fax Number :
Provider Business Practice Location Address
First Line : 118 E 8TH ST
Second Line :
City : PORT ANGELES
State : WA
Zip : 98362-6129
Country : US
Telephone Number : 360-457-0431
Fax Number : 360-457-0493
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 07/03/2019

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Directions to “ MS. TRICIA ANN VAIL LICSW” Practice Location

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