Jessica Lynn Supinski | Vancouver, WA • PECOS Search

Jessica Lynn Supinski

Counselor

Behavioral Health & Social Service Providers

1014 Main Street, Vancouver, WA 98661

PECOS Enrollment

Based on the most recent information from CMS, provider Jessica Lynn Supinski does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1659675387
Provider Type
Individual
Full Name
Supinski, Jessica Lynn
Title
Mrs.
Credential
BA

Gender
Female
Sole Proprietor
Yes
Enumeration Date
1/10/2011
Last Updated
1/6/2012

Contact Information

Practice Location

1014 Main Street, Vancouver, WA 98661

(360) 750-1374

Mailing Location

1014 Main Street, Vancouver, WA 98661

(360) 750-1374

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License CG60181044 Washington