Individual
JAEREN ANTHONY DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW, QMHP-C
Contact information
Practice address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
(360) 256-2000
(360) 514-2548
Mailing address
3601 V ST, VANCOUVER, WA 98663-2622
(503) 754-2834
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
THW00071
OR
1041C0700X
Clinical Social Worker
Primary
LW61031767
WA
Other
Enumeration date
09/29/2014
Last updated
01/17/2024
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