Healthcare Provider Details

I. General information

NPI: 1821105214
Provider Name (Legal Business Name): JOAN MCPHERSON FOREST LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 NE MIDWAY BLVD STE B206A
OAK HARBOR WA
98277-2642
US

IV. Provider business mailing address

2620 DREAMLAND LN
LANGLEY WA
98260-8108
US

V. Phone/Fax

Practice location:
  • Phone: 360-969-5583
  • Fax: 360-246-9218
Mailing address:
  • Phone: 360-969-5583
  • Fax: 360-246-9218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00009560
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: