Healthcare Provider Details

I. General information

NPI: 1932473238
Provider Name (Legal Business Name): ASSOCIATES FOR PSYCHIATRIC & MENTAL HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2012
Last Update Date: 05/10/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 F STREET
VANCOUVER WA
98663
US

IV. Provider business mailing address

2600 F STREET
VANCOUVER WA
98663
US

V. Phone/Fax

Practice location:
  • Phone: 360-448-7827
  • Fax: 503-914-1404
Mailing address:
  • Phone: 360-448-7827
  • Fax: 503-914-1404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number200344
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberAP60035777
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number200344
License Number StateWA

VIII. Authorized Official

Name: SHEELA M CHOPPALA-NESTOR
Title or Position: OWNER AND CEO
Credential: PHD, PMHNP-BC, ARNP
Phone: 360-448-7827