Provider Demographics
NPI:1477318566
Name:DCB WELLNESS HEALTH SERVICES PLLC
Entity Type:Organization
Organization Name:DCB WELLNESS HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:CHADIKA
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:678-760-6321
Mailing Address - Street 1:253 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-1215
Mailing Address - Country:US
Mailing Address - Phone:678-760-6321
Mailing Address - Fax:
Practice Address - Street 1:253 25TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-1215
Practice Address - Country:US
Practice Address - Phone:678-760-6321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty