Provider Demographics
NPI:1811364227
Name:ADVENTURE LEARNING AND ASSESSMENT
Entity Type:Organization
Organization Name:ADVENTURE LEARNING AND ASSESSMENT
Other - Org Name:ADVENTURE PSYCHOLOGICAL SERVICES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANIE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DULEY
Authorized Official - Suffix:
Authorized Official - Credentials:RHIT
Authorized Official - Phone:360-718-6548
Mailing Address - Street 1:717 NE 61ST ST
Mailing Address - Street 2:#202
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8753
Mailing Address - Country:US
Mailing Address - Phone:360-718-6548
Mailing Address - Fax:360-718-6554
Practice Address - Street 1:717 NE 61ST ST
Practice Address - Street 2:#202
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8753
Practice Address - Country:US
Practice Address - Phone:360-718-6548
Practice Address - Fax:360-718-6554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-01
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60413305101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2050221Medicaid