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General NPI Number Information
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NPI Number | 1902578628
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Entity Type | Individual
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Provider Name | JAVEEN LYNETTE SKOUBO PSYD.
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Gender | Female
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 814 NE 87TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98664-1915
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Country | US
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Telephone | 360-910-1522
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Fax |
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Provider Business Mailing Address
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Address Line | 211 SE CARUTHERS ST
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City | PORTLAND
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State | OR
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Zip | 97214-4502
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Country | US
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Telephone | 503-224-1044
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Fax | 971-260-0355
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY61631633
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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 | R252
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License Number State | OR
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