| Vancouver Integrative Counseling | |
|
1711 Main St Vancouver WA 98660-2607 | |
| (360) 200-4481 | |
| (360) 799-4714 |
| Full Name | Vancouver Integrative Counseling |
|---|---|
| Speciality | Counselor |
| Location | 1711 Main St, Vancouver, Washington |
| Authorized Official Name and Position | Katie Grill (OWNER) |
| Authorized Official Contact | 3602004481 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vancouver Integrative Counseling 1711 Main St Vancouver WA 98660-2607 Ph: (360) 200-4481 | Vancouver Integrative Counseling 1711 Main St Vancouver WA 98660-2607 Ph: (360) 200-4481 |
| NPI Number | 1972090587 |
|---|---|
| Provider Enumeration Date | 04/18/2018 |
| Last Update Date | 10/04/2024 |
| Certification Date | 10/04/2024 |
| Medicare PECOS PAC ID | 8729337795 |
|---|---|
| Medicare Enrollment ID | O20180823003612 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972090587 | NPI | - | NPPES |
| Provider Name | Ruth E Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306125984 PECOS PAC ID: 6406020072 Enrollment ID: I20111116000400 |
| Provider Name | Jeanne M Fischer Mckee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295167393 PECOS PAC ID: 7012147309 Enrollment ID: I20140306001225 |
| Provider Name | Annemieke Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295239168 PECOS PAC ID: 6406107101 Enrollment ID: I20181001002837 |
| Provider Name | Jessica Boldt |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295867331 PECOS PAC ID: 3173872140 Enrollment ID: I20190102001606 |
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