Provider Demographics
NPI: | 1659157998 |
---|---|
Name: | LACAMAS VIEW MENTAL HEALTH |
Entity Type: | Organization |
Organization Name: | LACAMAS VIEW MENTAL HEALTH |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PMHNP |
Authorized Official - Prefix: | |
Authorized Official - First Name: | AMBER |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | CURTIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | APRN |
Authorized Official - Phone: | 480-206-8084 |
Mailing Address - Street 1: | 2005 SE 192ND AVE STE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | CAMAS |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98607-7475 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 360-585-4563 |
Mailing Address - Fax: | 360-282-1217 |
Practice Address - Street 1: | 2005 SE 192ND AVE STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | CAMAS |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98607-7475 |
Practice Address - Country: | US |
Practice Address - Phone: | 360-585-4563 |
Practice Address - Fax: | 360-282-1217 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-09-04 |
Last Update Date: | 2023-09-04 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |