| Clark County Juvenile Court | |
|
500 W 11th Street Vancouver WA 98660 | |
| (360) 397-2201 | |
| Not Available |
| Full Name | Clark County Juvenile Court |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 500 W 11th Street, Vancouver, Washington |
| Authorized Official Name and Position | Patrick M Escamilla (JUVENILE COURT ADMINISTRATOR) |
| Authorized Official Contact | 3603972201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark County Juvenile Court Po Box 5000 Vancouver WA 98666-5000 Ph: (360) 397-2201 | Clark County Juvenile Court 500 W 11th Street Vancouver WA 98660 Ph: (360) 397-2201 |
| NPI Number | 1790034627 |
|---|---|
| Provider Enumeration Date | 09/06/2012 |
| Last Update Date | 09/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790034627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | LF00001940 (Washington) | Primary |
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