Welliver, Raymond

Welliver, Raymond is an individual health care provider with primary practice located at 1010 E College Way , Mount Vernon WA 98273-5624. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Welliver, Raymond can be contacted via phone (360) 542-8920.

Contact Information

Primary practice address
1010 E College Way Mount Vernon WA 98273-5624
Phone: (360) 542-8920
Fax: (360) 542-8930
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 1030657 Massachusetts
Behavioral Health & Social Service Providers / Clinical 1041C0700X LW60068846 Washington

Profile Details

NPI number 1114120144
LBN Legal business name Welliver, Raymond
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2007
Last updated Oct 5th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114120144 NPPES
Massachusetts MEDICAID 1307819

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