Provider Demographics
NPI:1750493623
Name:LANGER, DIANE M (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:LANGER
Suffix:
Gender:F
Credentials:LCSW
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12607 SE MILL PLAIN BLVD
Mailing Address - Street 2:KAISER PERMANENTE CASCADE PARK MEDICAL OFFICE
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6055
Mailing Address - Country:US
Mailing Address - Phone:360-944-2837
Mailing Address - Fax:360-896-4478
Practice Address - Street 1:12607 SE MILL PLAIN BLVD
Practice Address - Street 2:KAISER PERMANENTE CASCADE PARK MEDICAL OFFICE
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6055
Practice Address - Country:US
Practice Address - Phone:360-896-4460
Practice Address - Fax:360-896-4478
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WALW000078291041C0700X
ORL32261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical