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General NPI Number Information
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NPI Number | 1538927322
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Entity Type | Organization
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Legal Business Name | VIOLET IONE KASHEWA LLC
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 4400 NE 77TH AVE STE 275
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City | VANCOUVER
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State | WA
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Zip | 98662-6857
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Country | US
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Telephone | 564-218-4512
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Fax |
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Provider Business Mailing Address
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Address Line | 4400 NE 77TH AVE STE 275
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City | VANCOUVER
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State | WA
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Zip | 98662-6857
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Country | US
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Telephone | 564-218-4512
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VIOLET IONE KASHEWA
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Credential |
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Telephone | 564-218-4512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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