Provider Demographics
NPI:1356812614
Name:SPECTRUM MENTAL HEALTH
Entity type:Organization
Organization Name:SPECTRUM MENTAL HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROWAN
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-334-9942
Mailing Address - Street 1:12503 SE MILL PLAIN BLVD STE 123
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-4007
Mailing Address - Country:US
Mailing Address - Phone:360-334-9942
Mailing Address - Fax:425-242-3683
Practice Address - Street 1:12503 SE MILL PLAIN BLVD STE 123
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-4007
Practice Address - Country:US
Practice Address - Phone:360-334-9942
Practice Address - Fax:425-242-3683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty