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General NPI Number Information
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NPI Number | 1891125472
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Entity Type | Organization
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Legal Business Name | CO-VISION WELLNESS, INC
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Dates
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Enumeration Date | 11/19/2013
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Last Update Date | 11/19/2013
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Provider Practice Location Address
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Address Line | 3288 50TH ST CT NW BLDG C SUITE 200
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City | GIG HARBOR
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State | WA
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Zip | 98335
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Country | US
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Telephone | 253-691-6854
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1143
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City | GIG HARBOR
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State | WA
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Zip | 98335-3143
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Country | US
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Telephone | 253-691-6854
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARGARET R CLAIR
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Credential | LMHC
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Telephone | 253-691-6854
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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 | LH00005677
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License Number State | WA
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