Healthcare Provider Details

I. General information

NPI: 1548387632
Provider Name (Legal Business Name): LARYN K DOLE BA,RC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 4TH PLAIN BLVD
VANCOUVER WA
98661-3753
US

IV. Provider business mailing address

1601 E 4TH PLAIN BLVD
VANCOUVER WA
98661-3753
US

V. Phone/Fax

Practice location:
  • Phone: 360-397-8246
  • Fax:
Mailing address:
  • Phone: 360-397-8246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWIA.SC.70068679
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: