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General NPI Number Information
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NPI Number | 1578137857
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Entity Type | Organization
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Legal Business Name | NORTHWEST EMDR THERAPY LLC
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Dates
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Enumeration Date | 05/19/2021
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 7200 NE 41ST ST STE 100
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City | VANCOUVER
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State | WA
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Zip | 98662-7935
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Country | US
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Telephone | 360-953-3199
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Fax | 360-339-5498
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Provider Business Mailing Address
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Address Line | 7200 NE 41ST ST STE 100
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City | VANCOUVER
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State | WA
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Zip | 98662-7935
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Country | US
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Telephone | 360-953-3199
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Fax | 360-339-5498
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Authorized Official
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Title or Position | OWNER
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Name | VANESSA GRAFF
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Credential | LMHC, LPC
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Telephone | 360-953-3199
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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