Provider Demographics
NPI:1336891712
Name:GUNDERSON, ASHLEY GRACE (LMHC, LPC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:GRACE
Last Name:GUNDERSON
Suffix:
Gender:F
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 1:756 OFFICERS ROW
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3845
Mailing Address - Country:US
Mailing Address - Phone:425-477-9282
Mailing Address - Fax:866-775-1981
Practice Address - Street 1:756 OFFICERS ROW
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3845
Practice Address - Country:US
Practice Address - Phone:425-477-9282
Practice Address - Fax:866-775-1981
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60233044101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health