Provider Demographics
NPI:1891435160
Name:FORERO, JESSICA (RCSWI)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FORERO
Suffix:
Gender:F
Credentials:RCSWI
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 2171
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-2171
Mailing Address - Country:US
Mailing Address - Phone:360-204-5413
Mailing Address - Fax:
Practice Address - Street 1:5150 NW WHISPER ST
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8338
Practice Address - Country:US
Practice Address - Phone:360-204-5413
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor