Provider Demographics
NPI:1821248220
Name:SALE, JEANNETTE LYNN
Entity Type:Individual
Prefix:
First Name:JEANNETTE
Middle Name:LYNN
Last Name:SALE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2412 E 13TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-4702
Mailing Address - Country:US
Mailing Address - Phone:360-735-5226
Mailing Address - Fax:
Practice Address - Street 1:2412 E 13TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4702
Practice Address - Country:US
Practice Address - Phone:360-735-5226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker