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NPI Code Detail

MEDICARE: JO ANNE LABOFF LICSW

MEDICARE:   JO ANNE LABOFF  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 WorkerLW60159256WA

General Provider Information

NPI Number : 1841895315
Entity Type Code : Individual
Provider Name (Legal Business Name) : JO ANNE LABOFF LICSW
Provider Business Mailing Address
First Line : 3606 NE 42ND ST
Second Line :
City : SEATTLE
State : WA
Zip : 98105-5615
Country : US
Telephone Number : 206-281-1620
Fax Number :
Provider Business Practice Location Address
First Line : 3606 NE 42ND ST
Second Line :
City : SEATTLE
State : WA
Zip : 98105-5615
Country : US
Telephone Number : 206-281-1620
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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