Provider Demographics
NPI:1497385611
Name:BOWERS, ASHLEY (SUDP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BOWERS
Suffix:
Gender:F
Credentials:SUDP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:WORNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2394
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-8455
Mailing Address - Country:US
Mailing Address - Phone:360-200-5419
Mailing Address - Fax:360-200-6736
Practice Address - Street 1:1408 12TH AVE
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3822
Practice Address - Country:US
Practice Address - Phone:360-998-3050
Practice Address - Fax:360-200-6736
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2149201Medicaid