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NPI 1770094708

NPI 1770094708 : MCKAYLA FORSBERG : ASOTIN, WA

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General NPI Number Information
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    NPI Number           |    1770094708
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    Entity Type          |    Individual 
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    Provider Name        |    MCKAYLA FORSBERG
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/17/2017
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    Last Update Date     |    11/14/2025
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Provider Practice Location Address
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    Address Line         |    314 HAYS ST PO BOX 304
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    City                 |    ASOTIN
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    State                |    WA
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    Zip                  |    99402
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    Country              |    US
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    Telephone            |    509-254-3264
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    314 HAYS ST. PO BOX 304
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    City                 |    ASOTIN
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    State                |    WA
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    Zip                  |    99402
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    Country              |    US
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    Telephone            |    509-254-3264
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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       |    
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    License Number State |    
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