Individual
MS. MIA JEAN VANDERMEER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
2924 FALK RD, VANCOUVER, WA 98661-5604
(360) 690-3069
Mailing address
898 MILL ST, KELSO, WA 98626-2911
(971) 204-5681
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61578056
WA
Other
Enumeration date
03/15/2025
Last updated
03/15/2025
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