Organization
DIVERSE BEHAVIORAL HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARA BERNAL (OWNER)
(360) 533-3216
Entity
Organization
Contact information
Practice address
3516 7TH AVE SW STE A, OLYMPIA, WA 98502-5011
(360) 533-3216
Mailing address
PO BOX 5482, LACEY, WA 98509-5482
(360) 533-3216
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/20/2023
Last updated
09/20/2023
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