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NPI Code Detail

MEDICARE: MS. JO ANN WORTHINGTON

MEDICARE: MS. JO ANN WORTHINGTON
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 CounselorRC00027867WA

General Provider Information

NPI Number : 1427190669
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JO ANN WORTHINGTON
Provider Business Mailing Address
First Line : 3927 S SHERMAN ST
Second Line :
City : SPOKANE
State : WA
Zip : 99203-2734
Country : US
Telephone Number : 509-458-2716
Fax Number :
Provider Business Practice Location Address
First Line : 210 W SPRAGUE AVE
Second Line :
City : SPOKANE
State : WA
Zip : 99201-3627
Country : US
Telephone Number : 509-343-5052
Fax Number : 509-747-0609
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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