Provider Demographics
NPI:1871732255
Name:CULLEN, JEANNE (MSW)
Entity type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:CULLEN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4908 112TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-5143
Mailing Address - Country:US
Mailing Address - Phone:253-985-6560
Mailing Address - Fax:253-985-6561
Practice Address - Street 1:4908 112TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-5143
Practice Address - Country:US
Practice Address - Phone:253-985-6560
Practice Address - Fax:253-985-6561
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker