Provider Demographics
NPI:1194003590
Name:INEZ KATHLEEN RAY-ANNIS, MSW, P.S., INC.
Entity Type:Organization
Organization Name:INEZ KATHLEEN RAY-ANNIS, MSW, P.S., INC.
Other - Org Name:ANNIS COUNSELING & EVALUATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:INEZ
Authorized Official - Middle Name:KATHLEEN
Authorized Official - Last Name:RAY-ANNIS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-690-6550
Mailing Address - Street 1:9330 NE VANCOUVER MALL DRIVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662
Mailing Address - Country:US
Mailing Address - Phone:360-690-6550
Mailing Address - Fax:360-253-6424
Practice Address - Street 1:9330 NE VANCOUVER MALL DRIVE
Practice Address - Street 2:SUITE 203
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662
Practice Address - Country:US
Practice Address - Phone:360-690-6550
Practice Address - Fax:360-253-6424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-02
Last Update Date:2018-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2003490Medicaid
WA1457482440OtherINDIVIDUAL NPI