Provider Demographics
NPI:1437263514
Name:HORSTMAN, ANN MICHELE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MICHELE
Last Name:HORSTMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SE 124TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6066
Mailing Address - Country:US
Mailing Address - Phone:360-718-1433
Mailing Address - Fax:360-944-9765
Practice Address - Street 1:201 SE 124TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6066
Practice Address - Country:US
Practice Address - Phone:360-718-1433
Practice Address - Fax:360-944-9765
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001325103TC0700X
OR0996103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical