Provider Demographics
NPI:1689306912
Name:JASPER, LAYLA REBECCA (MSW)
Entity Type:Individual
Prefix:
First Name:LAYLA
Middle Name:REBECCA
Last Name:JASPER
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:PO BOX 937
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:WA
Mailing Address - Zip Code:98356-0937
Mailing Address - Country:US
Mailing Address - Phone:206-518-0797
Mailing Address - Fax:
Practice Address - Street 1:909 HARRIS AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7080
Practice Address - Country:US
Practice Address - Phone:360-734-0615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical