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General NPI Number Information
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NPI Number | 1235795493
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Entity Type | Organization
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Legal Business Name | NORTH CASCADE RECOVERY
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 317 S 2ND ST STE 104
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City | MOUNT VERNON
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State | WA
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Zip | 98273-3814
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Country | US
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Telephone | 360-707-4650
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Fax |
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Provider Business Mailing Address
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Address Line | 1558 PORTO BELLO AVE
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City | SEDRO WOOLLEY
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State | WA
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Zip | 98284-7428
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICSW
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Name | KELSY OZUNA
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Credential |
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Telephone | 360-707-4650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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