Provider Demographics
NPI:1942386016
Name:GRUSHKIN, DAVID (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GRUSHKIN
Suffix:
Gender:M
Credentials:LMHC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7507 NE 51ST ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6007
Mailing Address - Country:US
Mailing Address - Phone:360-903-1514
Mailing Address - Fax:360-906-1193
Practice Address - Street 1:7507 NE 51ST ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6007
Practice Address - Country:US
Practice Address - Phone:360-903-1514
Practice Address - Fax:360-906-1193
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005993101YM0800X
ORC1332101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health