Individual
JACKILYN IMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
945 11TH AVE, LONGVIEW, WA 98632-2555
(503) 720-4706
Mailing address
945 11TH AVE, LONGVIEW, WA 98632-2555
(503) 308-1161
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
LW61481125
WA
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
LW61481125
WA
Other
Enumeration date
04/30/2018
Last updated
04/13/2026
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