| Pacific Nw Relational Therapy, Pllc | |
|
4400 Ne 77th Ave Vancouver WA 98662-6829 | |
| (503) 765-6335 | |
| Not Available |
| Full Name | Pacific Nw Relational Therapy, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4400 Ne 77th Ave, Vancouver, Washington |
| Authorized Official Name and Position | Skylar Tharp-bittinger (LICENSED PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 5037656335 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pacific Nw Relational Therapy, Pllc 522 W Riverside Ave # 8395 Spokane WA 99201-0580 Ph: (503) 765-6335 | Pacific Nw Relational Therapy, Pllc 4400 Ne 77th Ave Vancouver WA 98662-6829 Ph: (503) 765-6335 |
| NPI Number | 1447008099 |
|---|---|
| Provider Enumeration Date | 05/08/2024 |
| Last Update Date | 05/08/2024 |
| Certification Date | 05/08/2024 |
| Medicare PECOS PAC ID | 0648719039 |
|---|---|
| Medicare Enrollment ID | O20241112002893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447008099 | NPI | - | NPPES |
| 1487998852 | Other | CO | NPI 1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Skylar Threasa Tharp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487998852 PECOS PAC ID: 2264739952 Enrollment ID: I20160323001827 |
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