Healthcare Provider Details

I. General information

NPI: 1669036174
Provider Name (Legal Business Name): RIVERWAY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

951 OFFICERS ROW
VANCOUVER WA
98661-3849
US

IV. Provider business mailing address

951 OFFICERS ROW
VANCOUVER WA
98661-3849
US

V. Phone/Fax

Practice location:
  • Phone: 360-838-3356
  • Fax: 360-326-1877
Mailing address:
  • Phone: 206-859-9805
  • Fax: 360-326-1877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MISS STEPHANIE M WICHMANN
Title or Position: OWNER/THERAPIST
Credential: LCSW/LICSW
Phone: 360-838-3356