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Organization
VIVID PSYCHIATRY LLC
Active
Organization
VIVID PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY MCGINNIS ARNP (OWNER)
(937) 479-3406
Entity
Organization
Contact information
Practice address
22443 SE 240TH ST STE 202, MAPLE VALLEY, WA 98038-5879
(937) 479-3406
(877) 894-5104
Mailing address
20606 SE 258TH PL, COVINGTON, WA 98042-6156
(937) 479-3406
(877) 894-5104
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
01/22/2019
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