MEDICARE: WCHS VANCOUVER TREATMENT SOLUTIONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2800X	Methadone Clinic

General Provider Information

NPI Number	:	1215074539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WCHS VANCOUVER TREATMENT SOLUTIONS

Provider Business Mailing Address
First Line	:	2009 NE 117TH ST
Second Line	:	SUITE 101
City	:	VANCOUVER
State	:	WA
Zip	:	98686-4022
Country	:	US
Telephone Number	:	360-566-9112
Fax Number	:	360-566-9133

Provider Business Practice Location Address
First Line	:	2009 NE 117TH ST
Second Line	:	SUITE 101
City	:	VANCOUVER
State	:	WA
Zip	:	98686-4022
Country	:	US
Telephone Number	:	360-566-9112
Fax Number	:	360-566-9133

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. HIREN T RANA
Credential	:	M.D.
Telephone Number	:	360-566-9112

Provider Enumeration Date	:	01/30/2007
Last Update Date	:	08/22/2020

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