Healthcare Provider Details

I. General information

NPI: 1073240487
Provider Name (Legal Business Name): JASMINE HARCUM MSW, LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 S 152ND ST APT C9
BURIEN WA
98148-2570
US

IV. Provider business mailing address

400 S 152ND ST APT C9
BURIEN WA
98148-2570
US

V. Phone/Fax

Practice location:
  • Phone: 425-444-1539
  • Fax:
Mailing address:
  • Phone: 425-224-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.70018074
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: