| Wild Remembrance Llc | |
|
23 Wnuk Rd White Salmon WA 98672-8428 | |
| (503) 705-5241 | |
| Not Available |
| Full Name | Wild Remembrance Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 23 Wnuk Rd, White Salmon, Washington |
| Authorized Official Name and Position | Elizabeth L Hummer (OWNER) |
| Authorized Official Contact | 5037055241 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Remembrance Llc 23 Wnuk Rd White Salmon WA 98672-8428 Ph: (503) 705-5241 | Wild Remembrance Llc 23 Wnuk Rd White Salmon WA 98672-8428 Ph: (503) 705-5241 |
| NPI Number | 1023690765 |
|---|---|
| Provider Enumeration Date | 04/22/2021 |
| Last Update Date | 04/22/2021 |
| Certification Date | 04/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023690765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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