Provider Demographics
NPI:1457680878
Name:MEYER, SERENA VALERIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:VALERIE
Last Name:MEYER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 MAIN ST.
Mailing Address - Street 2:SUITE 503
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660
Mailing Address - Country:US
Mailing Address - Phone:503-989-1152
Mailing Address - Fax:503-894-8745
Practice Address - Street 1:601 MAIN ST.
Practice Address - Street 2:SUITE 503
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660
Practice Address - Country:US
Practice Address - Phone:503-989-1152
Practice Address - Fax:503-894-8745
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60146043103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist