Provider Demographics
NPI:1285902874
Name:ST. JOHN, VALERIE C (MSC)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:C
Last Name:ST. JOHN
Suffix:
Gender:F
Credentials:MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 ROSEDALE ST STE 107
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1809
Mailing Address - Country:US
Mailing Address - Phone:360-580-1998
Mailing Address - Fax:866-619-3188
Practice Address - Street 1:3312 ROSEDALE ST STE 107
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1809
Practice Address - Country:US
Practice Address - Phone:360-529-3401
Practice Address - Fax:866-619-3188
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-09
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60252416101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2050321Medicaid