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NPI Code Detail

MEDICARE: MR. JASON GRAM LSWAIC

MEDICARE:  MR. JASON  GRAM  LSWAIC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorSWIA.SC.70098231WA
2104100000XSocial WorkerSWIA.SC.70098231WA

General Provider Information

NPI Number : 1023948049
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON GRAM LSWAIC
Provider Business Mailing Address
First Line : PO BOX 106
Second Line :
City : SNOQUALMIE
State : WA
Zip : 98065-0106
Country : US
Telephone Number : 425-241-8281
Fax Number : 425-241-8281
Provider Business Practice Location Address
First Line : 9050 384TH AVE SE
Second Line :
City : SNOQUALMIE
State : WA
Zip : 98065-9637
Country : US
Telephone Number : 425-888-3347
Fax Number : 425-888-2010
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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Directions to “ MR. JASON GRAM LSWAIC” Practice Location

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