Wirt, Jennifer Marcella
Wirt, Jennifer Marcella is an individual health care provider with primary practice located at 300 Ocean Ave , Raymond WA 98577-3016. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Wirt, Jennifer Marcella can be contacted via phone (360) 942-3040.Contact Information
Primary practice address
300 Ocean Ave
Raymond WA 98577-3016
Phone: (360) 942-3040
Fax: (360) 942-3955
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LH61306829 | Washington |
Profile Details
| NPI number | 1902409709 |
|---|---|
| LBN Legal business name | Wirt, Jennifer Marcella |
| Credentials | LMHC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2020 |
| Last updated | Sep 18th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902409709 | NPPES |
| Washington | MEDICAID | 2212708 |
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