Individual
CHARLENE PEDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CG
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3753
(360) 397-8246
Mailing address
PO BOX 1678, VANCOUVER, WA 98668-1678
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/23/2014
Last updated
04/23/2014
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