| Iredale Professional Services | |
|
1804 Se 170th Ave Vancouver WA 98683-3474 | |
| (360) 991-0134 | |
| (360) 991-0154 |
| Full Name | Iredale Professional Services |
|---|---|
| Speciality | Psychologist |
| Location | 1804 Se 170th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Trudy A Iredale (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 3609910134 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iredale Professional Services 1804 Se 170th Ave Vancouver WA 98683-3474 Ph: (360) 991-0134 | Iredale Professional Services 1804 Se 170th Ave Vancouver WA 98683-3474 Ph: (360) 991-0134 |
| NPI Number | 1841811783 |
|---|---|
| Provider Enumeration Date | 05/01/2020 |
| Last Update Date | 08/19/2020 |
| Certification Date | 08/19/2020 |
| Medicare PECOS PAC ID | 8628494424 |
|---|---|
| Medicare Enrollment ID | O20200811001886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841811783 | NPI | - | NPPES |
| 1841811783 | Other | TYPE II NPI | |
| 1770649402 | Other | NPI | |
| PY00003097 | Other | WA | WA STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Trudy A Iredale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770649402 PECOS PAC ID: 9931280583 Enrollment ID: I20080121000337 |
Fletcher Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Ne Park Plaza Dr, Suite 292, Vancouver, WA 98684 Phone: 360-524-5879 Fax: 360-326-1834 | |
Daybreak Vancouver Outpatient Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 11818 Se Mill Plain Blvd, Suite 307, Vancouver, WA 98684 Phone: 360-750-9635 Fax: 360-334-9541 | |
Sleep Health Clinic Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2501 Ne 134th St Ste 203, Vancouver, WA 98686 Phone: -- | |
Awaken Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4602 Ne 59th Ave, Vancouver, WA 98661 Phone: 503-410-3048 | |
Vancover Treatment Solutions Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2009 Ne 117th Street, Ste. 101, Vancouver, WA 98686 Phone: 360-566-9112 Fax: 360-566-9133 | |
Moontree Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3305 Main St Ste 23, Vancouver, WA 98663 Phone: 360-949-2727 | |
Dale B Mortimer Md Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10000 Ne 7th Ave, Suite 385, Vancouver, WA 98685 Phone: 360-882-9058 Fax: 360-567-0861 |