| Northwest Child And Family Clinic, P.c. | |
|
14619 Ne 82nd Ave Vancouver WA 98662-1057 | |
| (503) 636-4333 | |
| Not Available |
| Full Name | Northwest Child And Family Clinic, P.c. |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 14619 Ne 82nd Ave, Vancouver, Washington |
| Authorized Official Name and Position | Sharon Bast Gavora (PRESIDENT) |
| Authorized Official Contact | 5036364333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northwest Child And Family Clinic, P.c. 14619 Ne 82nd Ave Vancouver WA 98662-1057 Ph: (503) 636-4333 | Northwest Child And Family Clinic, P.c. 14619 Ne 82nd Ave Vancouver WA 98662-1057 Ph: (503) 636-4333 |
| NPI Number | 1902927478 |
|---|---|
| Provider Enumeration Date | 04/03/2007 |
| Last Update Date | 03/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902927478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1373 (Oregon) | Secondary |
| 103TC0700X | Psychologist - Clinical | TE00003919 (Washington) | Primary |
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