Basic Information
| Provider Information | |||||||||
| NPI: | 1942777198 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THOMASON | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | MSW, LSWAIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 BIRCH ST | ||||||||
| Address2: | |||||||||
| City: | CASHMERE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 988151103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5096700196 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1230 MONITOR ST | ||||||||
| Address2: | |||||||||
| City: | WENATCHEE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 988013534 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093001221 | ||||||||
| FaxNumber: | 5096634640 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2018 | ||||||||
| LastUpdateDate: | 10/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | SC60843630 | WA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.