Provider Demographics
NPI:1689887465
Name:FLEMING, JEANNE SWANSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEANNE
Middle Name:SWANSON
Last Name:FLEMING
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:783 COMMERCE AVENUE
Mailing Address - Street 2:200
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-2490
Mailing Address - Country:US
Mailing Address - Phone:360-423-2750
Mailing Address - Fax:360-423-2639
Practice Address - Street 1:783 COMMERCE AVENUE
Practice Address - Street 2:200
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2490
Practice Address - Country:US
Practice Address - Phone:360-423-2750
Practice Address - Fax:360-423-2639
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA814103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist