Healthcare Provider Details

I. General information

NPI: 1215751201
Provider Name (Legal Business Name): VERSA FORCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10637 NE COXLEY DR
VANCOUVER WA
98662-6119
US

IV. Provider business mailing address

19100 61ST AVE NE APT C
KENMORE WA
98028-3263
US

V. Phone/Fax

Practice location:
  • Phone: 971-381-7606
  • Fax:
Mailing address:
  • Phone: 971-381-7606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: STUART NKUBA
Title or Position: CEO
Credential:
Phone: 971-381-7606