Healthcare Provider Details

I. General information

NPI: 1235080797
Provider Name (Legal Business Name): ASHLEY ROSE POND
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4526 FEDERAL AVE
EVERETT WA
98203-2132
US

IV. Provider business mailing address

39303 PLAGMAN DR
LEBANON OR
97355-9786
US

V. Phone/Fax

Practice location:
  • Phone: 360-678-5555
  • Fax: 360-251-9173
Mailing address:
  • Phone: 541-451-0133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: