Provider Demographics
NPI:1699916114
Name:CLARK COUNTY
Entity type:Organization
Organization Name:CLARK COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNTY ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BILL
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-397-2130
Mailing Address - Street 1:PO BOX 5000
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-5000
Mailing Address - Country:US
Mailing Address - Phone:360-397-8198
Mailing Address - Fax:360-397-8476
Practice Address - Street 1:1601 NE 4TH PLAIN BLVD
Practice Address - Street 2:BLDG. #17 STE. A-150
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661
Practice Address - Country:US
Practice Address - Phone:360-397-8198
Practice Address - Fax:360-397-8476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA237251S00000X
WA140251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health