| Vancouver Clinical Services Pc | |
|
3305 Main St Ste 306 Vancouver WA 98663-2251 | |
| (360) 695-7588 | |
| (360) 695-2982 |
| Full Name | Vancouver Clinical Services Pc |
|---|---|
| Speciality | Counselor |
| Location | 3305 Main St Ste 306, Vancouver, Washington |
| Authorized Official Name and Position | Jeannette Bateman (MSW,LICSW) |
| Authorized Official Contact | 3606957588 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vancouver Clinical Services Pc 2114 Main St Ste 100 Vancouver WA 98660-2674 Ph: (360) 695-7588 | Vancouver Clinical Services Pc 3305 Main St Ste 306 Vancouver WA 98663-2251 Ph: (360) 695-7588 |
| NPI Number | 1396247912 |
|---|---|
| Provider Enumeration Date | 02/28/2018 |
| Last Update Date | 10/09/2019 |
| Medicare PECOS PAC ID | 8628331063 |
|---|---|
| Medicare Enrollment ID | O20180417000852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396247912 | NPI | - | NPPES |
| 11662866 | Other | CAQH# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Washington) | Primary |
| Provider Name | Jeannette R Bateman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770550881 PECOS PAC ID: 6204098759 Enrollment ID: I20120430000762 |
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