Healthcare Provider Details

I. General information

NPI: 1356812614
Provider Name (Legal Business Name): SPECTRUM MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12503 SE MILL PLAIN BLVD STE 123
VANCOUVER WA
98684-4007
US

IV. Provider business mailing address

12503 SE MILL PLAIN BLVD STE 123
VANCOUVER WA
98684-4007
US

V. Phone/Fax

Practice location:
  • Phone: 360-334-9942
  • Fax: 425-242-3683
Mailing address:
  • Phone: 360-334-9942
  • Fax: 425-242-3683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: RHONDA ROWAN
Title or Position: OWNER
Credential: ARNP
Phone: 360-334-9942