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1601 E 4th Plain Blvd Vancouver WA 98661-3753 | |
| (360) 397-8474 | |
| (360) 397-8481 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1601 E 4th Plain Blvd, Vancouver, Washington |
| Authorized Official Name and Position | Marshall Langfeld (SVP, CFO) |
| Authorized Official Contact | 5103377950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1080 Marina Village Parkway Suite 100 Alameda CA 94501-1078 Ph: (510) 337-7950 | 1601 E 4th Plain Blvd Vancouver WA 98661-3753 Ph: (360) 397-8474 |
| NPI Number | 1699162925 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 04/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699162925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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