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General NPI Number Information
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NPI Number | 1326570532
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Entity Type | Individual
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Provider Name | JANETTE LYNN PENNINGTON CSWA
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Gender | Female
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 1219 SW 4TH AVE
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City | ONTARIO
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State | OR
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Zip | 97914-4566
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Country | US
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Telephone | 541-889-2668
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Fax |
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Provider Business Mailing Address
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Address Line | 125 NW 2ND ST
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City | ONTARIO
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State | OR
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Zip | 97914-2413
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Country | US
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Telephone | 208-739-3230
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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 | A4693
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License Number State | OR
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