Provider Demographics
NPI:1861739773
Name:SEAY, JESSICA LEONORA (LCSW, LSWAIC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LEONORA
Last Name:SEAY
Suffix:
Gender:F
Credentials:LCSW, LSWAIC
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEONORA
Other - Last Name:GUTIERREZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3423 NE KINGBIRD ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-6907
Mailing Address - Country:US
Mailing Address - Phone:360-810-8870
Mailing Address - Fax:
Practice Address - Street 1:3423 NE KINGBIRD ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-6907
Practice Address - Country:US
Practice Address - Phone:360-810-8870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-11
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND47061041C0700X
WA610641731041C0700X
WA611008711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical