Individual
JASON ANDREW HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSW, MSW
Contact information
Practice address
711 E 3RD AVE, SPOKANE, WA 99202-2211
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60391096
WA
1041C0700X
Clinical Social Worker
Primary
SC61094840
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1041C0700X
SOCIAL WORKER- CLINICAL
WA
Enumeration date
11/06/2018
Last updated
07/14/2021
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