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General NPI Number Information
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NPI Number | 1013495043
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Entity Type | Organization
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Legal Business Name | JOAN MCPHERSON FOREST I
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Dates
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Enumeration Date | 08/01/2018
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Last Update Date | 01/17/2021
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Provider Practice Location Address
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Address Line | 390 NE MIDWAY BLVD STE B206A
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City | OAK HARBOR
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State | WA
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Zip | 98277-2642
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Country | US
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Telephone | 360-969-5583
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 DREAMLAND LN
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City | LANGLEY
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State | WA
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Zip | 98260-8108
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Country | US
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Telephone | 360-969-5583
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Fax | 360-246-9218
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Authorized Official
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Title or Position | OWNER
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Name | JOAN FOREST
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Credential | LICSW
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Telephone | 360-969-5583
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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