Healthcare Provider Details

I. General information

NPI: 1538630850
Provider Name (Legal Business Name): HERITAGE NW CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5411 NE 107TH AVE STE 101
VANCOUVER WA
98662-6347
US

IV. Provider business mailing address

5411 NE 107TH AVE STE 101
VANCOUVER WA
98662-6347
US

V. Phone/Fax

Practice location:
  • Phone: 360-828-7871
  • Fax:
Mailing address:
  • Phone: 360-828-7871
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: RAMONA J ROBINSON
Title or Position: CASE WORKER
Credential: MSW
Phone: 360-936-6207