Healthcare Provider Details
I. General information
NPI: 1346715794
Provider Name (Legal Business Name): RAMONDA DAWN VERNON M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/11/2018
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
326 SE MARLIN AVE
WARRENTON OR
97146-9624
US
IV. Provider business mailing address
65 N HIGHWAY 101 STE 204
WARRENTON OR
97146-9371
US
V. Phone/Fax
- Phone: 503-325-5722
- Fax: 503-861-5649
- Phone: 503-325-5722
- Fax: 503-861-2043
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | CG60279646 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: