Individual provider Active NPI

Inez Kathleen Ray-Annis, LICSW

  • Clinical Social Worker
  • Vancouver, WA
National Provider Identifier
1457482440
Registry record updated Sep 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW 00009698 Issued in WA
Practice address
8000 NE Parkway Dr Ste 200
Vancouver, WA 98662-6737
Phone
(360) 690-6550
Fax
(360) 253-6424
NPI assigned
Mar 8, 2007
Last updated
Sep 24, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU
Clinical Social Worker 1041C0700X LW 00009698 WA Primary

Addresses

Primary practice location

8000 NE Parkway Dr Ste 200
Vancouver, WA 98662-6737

Mailing address

4205 NE 151St Ave
Vancouver, WA 98682-7074
Phone (360) 690-6550

Other identifiers 2

IdentifierTypeStateIssuer
LW 00009698OtherWALICENSED CLINICAL SOCIAL WORKER (LICSW)
RC00048802OtherWAREGISTER COUNSELOR

Other names 1

  • Kathie Ray-Annis Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111102000944 WA Practitioner - Clinical Social Worker 6204009442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9407 NE Vancouver Mall Dr
Suite 107
Vancouver, WA 98662-6191
Phone (360) 690-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LW 00009698WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Inez Kathleen Ray-Annis, MSW, P.S., Inc. Clinical CurrentSince Jul 31, 2011 Accepting new patients

Locations

8000 NE Parkway Dr
Ste 200
Vancouver, WA 98662
Phone (360) 690-6550

9407 NE Vancouver Mall Dr
#107
Vancouver, WA 98662

9407 NE Vancouver Mall Dr
Ste 107
Vancouver, WA 98662
Phone (360) 690-6550

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253750400000",
    "number": "1457482440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 NE 151ST AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986827074",
            "telephone_number": "360-690-6550",
            "fax_number": "360-253-6424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 NE PARKWAY DR STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626737",
            "telephone_number": "360-690-6550",
            "fax_number": "360-253-6424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY-ANNIS",
        "first_name": "INEZ",
        "middle_name": "KATHLEEN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2009-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW 00009698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED CLINICAL SOCIAL WORKER (LICSW)",
            "identifier": "LW 00009698",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTER COUNSELOR",
            "identifier": "RC00048802",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHIE",
            "last_name": "RAY-ANNIS",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.