Healthcare Provider Details

I. General information

NPI: 1750219184
Provider Name (Legal Business Name): SONGBIRD PSYCHOLOGICAL SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 E 15TH ST STE 10
VANCOUVER WA
98663-3451
US

IV. Provider business mailing address

404 E 15TH ST STE 10
VANCOUVER WA
98663-3451
US

V. Phone/Fax

Practice location:
  • Phone: 971-319-3536
  • Fax:
Mailing address:
  • Phone: 971-319-3536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. BETHANY DEHAVEN
Title or Position: OWNER
Credential: PSYD
Phone: 971-319-3536