Provider Demographics
NPI:1366114951
Name:LA TONA, JAIME ANNE (LH61531731)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:ANNE
Last Name:LA TONA
Suffix:
Gender:F
Credentials:LH61531731
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 NE 164TH ST APT S1
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:98642-8932
Mailing Address - Country:US
Mailing Address - Phone:949-294-4584
Mailing Address - Fax:
Practice Address - Street 1:2500 NE 65TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6812
Practice Address - Country:US
Practice Address - Phone:360-952-3372
Practice Address - Fax:360-750-9706
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-01
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61531731101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty