Provider Demographics
NPI:1396562021
Name:BARNETTE, LORRAINE RAYANN (SUDP)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:RAYANN
Last Name:BARNETTE
Suffix:
Gender:F
Credentials:SUDP
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:RAYANN
Other - Last Name:STONER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:420 HOWANUT RD
Mailing Address - Street 2:
Mailing Address - City:OAKVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98568-9659
Mailing Address - Country:US
Mailing Address - Phone:360-709-1682
Mailing Address - Fax:707-274-4628
Practice Address - Street 1:420 HOWANUT RD
Practice Address - Street 2:
Practice Address - City:OAKVILLE
Practice Address - State:WA
Practice Address - Zip Code:98568-9659
Practice Address - Country:US
Practice Address - Phone:360-709-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-24
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP61446517101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)