Provider Demographics
NPI:1366216004
Name:LOWTHIAN, JENNA COLLEEN (MSW)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:COLLEEN
Last Name:LOWTHIAN
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 1:1202 NW REDWING DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9280
Mailing Address - Country:US
Mailing Address - Phone:303-829-0804
Mailing Address - Fax:
Practice Address - Street 1:1315 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4134
Practice Address - Country:US
Practice Address - Phone:360-812-5188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker