Healthcare Provider Details

I. General information

NPI: 1447737283
Provider Name (Legal Business Name): JILLIAN MONET LEE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 8TH ST STE 110
VANCOUVER WA
98660-3294
US

IV. Provider business mailing address

PO BOX 871021
VANCOUVER WA
98687-1021
US

V. Phone/Fax

Practice location:
  • Phone: 360-233-2934
  • Fax:
Mailing address:
  • Phone: 360-233-2934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL7742
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: