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General NPI Number Information
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NPI Number | 1053476457
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Entity Type | Individual
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Provider Name | BJ SOLBERG LCSW, CDMHP
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 105 N. FIRST ST.
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City | COUPEVILLE
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State | WA
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Zip | 98239
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Country | US
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Telephone | 369-678-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 11859 OLGA RD
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City | ANACORTES
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State | WA
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Zip | 98221-8795
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Country | US
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Telephone | 360-299-3199
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | LW00005054
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License Number State | WA
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