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General NPI Number Information
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NPI Number | 1811792609
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Entity Type | Organization
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Legal Business Name | JEANETTE EDMISTER PLLC
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Dates
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Enumeration Date | 02/15/2025
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Last Update Date | 02/15/2025
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Provider Practice Location Address
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Address Line | 3305 MAIN ST STE 9
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City | VANCOUVER
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State | WA
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Zip | 98663-2272
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Country | US
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Telephone | 971-270-0093
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 NE 154TH ST
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City | VANCOUVER
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State | WA
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Zip | 98686-1410
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Country | US
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Telephone | 360-513-2835
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEANETTE EDMISTER
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Credential | LMHC
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Telephone | 360-513-2835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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