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General NPI Number Information
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NPI Number | 1518131705
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Entity Type | Individual
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Provider Name | JESSICA VORNBROCK MSW
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Gender | Female
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 16150 NE 85TH ST STE 121
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City | REDMOND
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State | WA
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Zip | 98052-3542
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Country | US
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Telephone | 425-698-3154
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Fax |
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Provider Business Mailing Address
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Address Line | 9109 32ND AVE NE
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City | SEATTLE
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State | WA
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Zip | 98115-3516
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Country | US
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Telephone | 206-538-7490
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | RC00052436
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LW60278077
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License Number State | WA
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