Provider Demographics
NPI:1700993755
Name:LANPHERE, JEANNE K (ATA)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:K
Last Name:LANPHERE
Suffix:
Gender:F
Credentials:ATA
Other - Prefix:
Other - First Name:JEANNE
Other - Middle Name:K
Other - Last Name:BECKTEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ATA
Mailing Address - Street 1:1100 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-4209
Mailing Address - Country:US
Mailing Address - Phone:360-419-3543
Mailing Address - Fax:360-419-3505
Practice Address - Street 1:1100 S 2ND ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-4209
Practice Address - Country:US
Practice Address - Phone:360-419-3543
Practice Address - Fax:360-419-3505
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00029876101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health