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General NPI Number Information
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NPI Number | 1710770433
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Entity Type | Individual
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Provider Name | GREG GOVAN
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Gender | Male
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Dates
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Enumeration Date | 05/26/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 1534 BISHOP RD SW
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City | TUMWATER
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State | WA
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Zip | 98512-7354
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Country | US
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Telephone | 360-357-2370
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Fax |
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Provider Business Mailing Address
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Address Line | 2835 CALAIS LN NW
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City | OLYMPIA
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State | WA
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Zip | 98502-3931
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Country | US
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Telephone | 360-280-8522
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 103K00000X
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 101YM0800X
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License Number State | WA
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