| Family Renewal | |
|
2015 Ne 96th Ct Vancouver WA 98664-2980 | |
| (425) 647-5775 | |
| (360) 340-9353 |
| Full Name | Family Renewal |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2015 Ne 96th Ct, Vancouver, Washington |
| Authorized Official Name and Position | Nicole Laurent (OWNER) |
| Authorized Official Contact | 4256475775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Renewal 2015 Ne 96th Ct Vancouver WA 98664-2980 Ph: (425) 647-5775 | Family Renewal 2015 Ne 96th Ct Vancouver WA 98664-2980 Ph: (425) 647-5775 |
| NPI Number | 1356782528 |
|---|---|
| Provider Enumeration Date | 07/16/2013 |
| Last Update Date | 10/12/2021 |
| Certification Date | 10/12/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356782528 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LH60550441 (Washington) | Primary |
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