Individual
JAN MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6304 W RICHARDSON RD, PASCO, WA 99301-1911
(509) 851-3280
(509) 349-5069
Mailing address
8350 W GRANDRIDGE BLVD STE 200, KENNEWICK, WA 99336-1678
(509) 851-3280
(509) 349-5069
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60549928
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
03/23/2013
Last updated
09/19/2022
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