| Community Services Northwest | |
|
1601 E Fourth Plain Blvd Bldg 17 Suite B222 Vancouver WA 98661-3753 | |
| (360) 397-8484 | |
| (360) 397-8494 |
| Full Name | Community Services Northwest |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1601 E Fourth Plain Blvd, Vancouver, Washington |
| Authorized Official Name and Position | John P. Moren (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3603978005 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Services Northwest Po Box 1845 Vancouver WA 98668-1845 Ph: (360) 397-8484 | Community Services Northwest 1601 E Fourth Plain Blvd Bldg 17 Suite B222 Vancouver WA 98661-3753 Ph: (360) 397-8484 |
| NPI Number | 1720176894 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 02/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720176894 | NPI | - | NPPES |
| 1994615 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 602-237-149 (Washington) | Secondary |
| 251S00000X | Community/behavioral Health | (Washington) | Primary |
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