| Daybreak Vancouver Outpatient | |
|
11818 Se Mill Plain Blvd Suite 307 Vancouver WA 98684 | |
| (360) 750-9635 | |
| (360) 334-9541 |
| Full Name | Daybreak Vancouver Outpatient |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 11818 Se Mill Plain Blvd, Vancouver, Washington |
| Authorized Official Name and Position | Thomas Russell (CEO) |
| Authorized Official Contact | 5094447033 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Daybreak Vancouver Outpatient 960 E 3rd Ave Spokane WA 99202-2241 Ph: (509) 444-7033 | Daybreak Vancouver Outpatient 11818 Se Mill Plain Blvd Suite 307 Vancouver WA 98684 Ph: (360) 750-9635 |
| NPI Number | 1003199712 |
|---|---|
| Provider Enumeration Date | 09/20/2011 |
| Last Update Date | 09/22/2022 |
| Certification Date | 09/22/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003199712 | NPI | - | NPPES |
| 2015313 | Medicaid | WA | |
| 155400 | Other | WA | WA STATE DBHR |
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