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General NPI Number Information
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NPI Number | 1679807515
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Entity Type | Organization
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Legal Business Name | GORMAN & ASSOCIATES, LLC
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 09/24/2009
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Provider Practice Location Address
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Address Line | 5275 APRIL DR
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City | LANGLEY
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State | WA
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Zip | 98260-9773
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Country | US
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Telephone | 360-321-7226
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Fax | 360-321-2674
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Provider Business Mailing Address
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Address Line | 5275 APRIL DR
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City | LANGLEY
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State | WA
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Zip | 98260-9773
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Country | US
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Telephone | 360-321-7226
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Fax | 360-321-2674
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Authorized Official
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Title or Position | MANAGER
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Name | MS. JUDITH E GORMAN
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Credential | MSW, LICSW
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Telephone | 360-321-7226
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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 | LW00005800
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License Number State | WA
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