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NPI Code Detail

MEDICARE: MRS. JENNIFER CHARLOTTE BARBER LICSW

MEDICARE: MRS. JENNIFER CHARLOTTE BARBER LICSW
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
11041C0700XClinical Social WorkerLW60232695WA

General Provider Information

NPI Number : 1841540671
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER CHARLOTTE BARBER LICSW
Provider Business Mailing Address
First Line : 821 NW 58TH ST
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-1192
Country : US
Telephone Number : 360-524-2045
Fax Number :
Provider Business Practice Location Address
First Line : 601 E MCLOUGHLIN BLVD
Second Line :
City : VANCOUVER
State : WA
Zip : 98663-3358
Country : US
Telephone Number : 360-524-2045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2012
Last Update Date : 09/19/2012

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