Healthcare Provider Details

I. General information

NPI: 1013392844
Provider Name (Legal Business Name): JAIME LEE VOSBEIN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. JAMIE LEE CLARK

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N WALL ST STE 202
SPOKANE WA
99201-0822
US

IV. Provider business mailing address

1307 E INDIANA AVE
SPOKANE WA
99207-2571
US

V. Phone/Fax

Practice location:
  • Phone: 537-527-3202
  • Fax:
Mailing address:
  • Phone: 504-621-8033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW61461160
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSA61107665
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number12676
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: