Individual
JESSICA A DE LARWELLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
(425) 261-1515
Mailing address
2930 MAPLE ST, EVERETT, WA 98201-3832
(425) 261-1500
(425) 261-1515
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8707-123
WI
104100000X
Social Worker
Primary
LW60877309
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
UNKNOWN
—
WA
Enumeration date
06/18/2021
Last updated
02/25/2023
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