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General NPI Number Information
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NPI Number | 1699365890
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Entity Type | Organization
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Legal Business Name | GATHER CHURCH
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Dates
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Enumeration Date | 01/21/2021
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 727 N TOWER AVE
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City | CENTRALIA
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State | WA
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Zip | 98531-4754
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Country | US
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Telephone | 360-827-0264
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 144
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City | CENTRALIA
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State | WA
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Zip | 98531-0144
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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 | ASSOCIATE PASTOR/SUPERVISOR
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Name | PATRICIA MARIE HOWARD
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Credential |
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Telephone | 360-827-1537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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