Provider Demographics
NPI:1003957721
Name:MISCHO, DEBORAH JEANNE (MSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:JEANNE
Last Name:MISCHO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:JEANNE
Other - Last Name:ERNST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:3502 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2221
Mailing Address - Country:US
Mailing Address - Phone:253-363-8484
Mailing Address - Fax:
Practice Address - Street 1:2522 N PROCTOR ST # 151
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-5338
Practice Address - Country:US
Practice Address - Phone:206-414-8963
Practice Address - Fax:206-420-0332
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251361041C0700X
WALW602012291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty