| Wild Heart Society Pllc | |
|
15604 Ne 28th Ave Vancouver WA 98686-1541 | |
| (360) 521-3055 | |
| Not Available |
| Full Name | Wild Heart Society Pllc |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 15604 Ne 28th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Mackenzie Dunham (PARTNER/THERAPIST) |
| Authorized Official Contact | 3605213055 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Heart Society Pllc 15604 Ne 28th Ave Vancouver WA 98686-1541 Ph: () - | Wild Heart Society Pllc 15604 Ne 28th Ave Vancouver WA 98686-1541 Ph: (360) 521-3055 |
| NPI Number | 1700344298 |
|---|---|
| Provider Enumeration Date | 03/04/2019 |
| Last Update Date | 03/04/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700344298 | NPI | - | NPPES |
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