Provider Demographics
NPI:1497819718
Name:SINES, LUANN LEE (LCS W)
Entity Type:Individual
Prefix:MRS
First Name:LUANN
Middle Name:LEE
Last Name:SINES
Suffix:
Gender:F
Credentials:LCS W
Other - Prefix:MS
Other - First Name:LUANN
Other - Middle Name:LEE
Other - Last Name:HANNUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:
Practice Address - Street 1:12800 BOTHELL EVERETT HWY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6642
Practice Address - Country:US
Practice Address - Phone:425-316-5062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004522104100000X, 1041C0700X
VA09040060861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0132OtherCARE FIRST BCBS
VA306422OtherAMERIGROUP VIRGINIA INC.
VA004945026Medicaid