Provider Demographics
NPI:1518131705
Name:VORNBROCK, JESSICA (MSW)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:VORNBROCK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9109 32ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3516
Mailing Address - Country:US
Mailing Address - Phone:206-538-7490
Mailing Address - Fax:
Practice Address - Street 1:16150 NE 85TH ST STE 121
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3542
Practice Address - Country:US
Practice Address - Phone:425-698-3154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00052436101Y00000X
WALW602780771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor