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General NPI Number Information
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NPI Number | 1770550881
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Entity Type | Individual
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Provider Name | JEANNETTE RUTH BATEMAN MSW
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Gender | Female
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 3305 MAIN ST STE 306
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City | VANCOUVER
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State | WA
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Zip | 98663-2251
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Country | US
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Telephone | 360-695-7588
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Fax | 360-695-2982
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Provider Business Mailing Address
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Address Line | 2114 MAIN ST STE 100
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City | VANCOUVER
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State | WA
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Zip | 98660-2674
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Country | US
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Telephone | 360-695-7588
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Fax | 360-695-2982
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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 | LW00005346
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License Number State | WA
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