Healthcare Provider Details

I. General information

NPI: 1295647386
Provider Name (Legal Business Name): OKANOGAN TMS & WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 PINE STREET
OKANOGAN WA
98840-9421
US

IV. Provider business mailing address

849 3RD AVE N
OKANOGAN WA
98840-9421
US

V. Phone/Fax

Practice location:
  • Phone: 509-861-8416
  • Fax:
Mailing address:
  • Phone: 509-861-8416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL

VIII. Authorized Official

Name: VANESSA MILLER
Title or Position: OWNER, PROVIDER
Credential: DNP, PMHNP-BC
Phone: 509-861-8416