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General NPI Number Information
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NPI Number | 1306519319
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Entity Type | Organization
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Legal Business Name | FIRCREST BH PLLC
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 811 NE 112TH AVE STE 108
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City | VANCOUVER
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State | WA
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Zip | 98684-5115
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Country | US
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Telephone | 949-981-9835
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Fax |
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Provider Business Mailing Address
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Address Line | 5611 NE 75TH ST
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City | VANCOUVER
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State | WA
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Zip | 98661-1053
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Country | US
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Telephone | 949-981-9835
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AYNSLEY BARRIEMORE SILVA
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Credential |
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Telephone | 949-981-9835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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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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