Healthcare Provider Details

I. General information

NPI: 1568383370
Provider Name (Legal Business Name): CALVARY CHAPEL VANCOUVER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6503 E MILL PLAIN BLVD STE E
VANCOUVER WA
98661-7406
US

IV. Provider business mailing address

6503 E MILL PLAIN BLVD STE E
VANCOUVER WA
98661-7406
US

V. Phone/Fax

Practice location:
  • Phone: 360-947-9865
  • Fax:
Mailing address:
  • Phone: 360-947-9865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ERIK HOLCOMB
Title or Position: DIRECTOR
Credential:
Phone: 360-947-9865