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NPI Code Detail

MEDICARE: JEANETTE FAYE PALMER BA

MEDICARE: JEANETTE FAYE PALMER BA
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCP00002844WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285780858
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEANETTE FAYE PALMER BA
Provider Business Mailing Address
First Line : PO BOX 34703
Second Line :
City : SEATTLE
State : WA
Zip : 98124-1703
Country : US
Telephone Number : 206-764-0112
Fax Number : 206-764-0489
Provider Business Practice Location Address
First Line : 1603 E ILLINOIS ST
Second Line :
City : BELLINGHAM
State : WA
Zip : 98226-3644
Country : US
Telephone Number : 360-647-4266
Fax Number : 360-647-6057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/26/2007
Last Update Date : 07/08/2007

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Directions to “ JEANETTE FAYE PALMER BA” Practice Location

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