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General NPI Number Information
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NPI Number | 1184250904
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Entity Type | Organization
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Legal Business Name | THREE TREES COUNSELING
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Dates
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Enumeration Date | 03/13/2020
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 406 SE 131ST AVE STE 303
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City | VANCOUVER
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State | WA
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Zip | 98683-4014
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Country | US
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Telephone | 425-652-6775
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Fax |
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Provider Business Mailing Address
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Address Line | 8243 SE 322ND PL
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City | GRESHAM
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State | OR
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Zip | 97080-8806
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Country | US
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Telephone | 425-652-6775
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Fax |
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | KRISTINA JEANNE FANT
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Credential |
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Telephone | 425-652-6775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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