Individual ProviderHailee RothSocial WorkerBehavioral Health & Social Service ProvidersPractice Address9300 NE Oak View Dr, Vancouver, WA 98662-6157(360) 567-2211(360) 334-1833PECOS EnrollmentBased on the most recent information from CMS, provider Hailee Roth does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1861974032Provider TypeIndividualFull NameRoth, HaileeGenderFemaleSole ProprietorYesEnumeration Date9/4/2018Last Updated12/28/2018Contact InformationPractice LocationPractice Address9300 NE Oak View Dr, Vancouver, WA 98662-6157Phone(360) 567-2211FaxUnlisted FaxMailing LocationMailing Address11803 NE 124th Ave Apt G115, Vancouver, WA 98682-2094Phone(360) 334-1833FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerWashingtonCode103TS0200XDescriptionPsychologistBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerWashingtonProvider IdentifiersIDDescriptionIssuerID1558593350DescriptionMedicaidIssuerUnlistedWashingtonID1861974032DescriptionMedicaidIssuerUnlistedWashington