Organization
EVERGREEN COUNSELING SERVICES, PC
Active
Other names
Evergreen Counseling Services, PS
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE EDWARD WOTRING LICSW (PRESIDENT)
(360) 694-3040
Entity
Organization
Contact information
Practice address
1104 MAIN ST, SUITE #440, VANCOUVER, WA 98660-2999
(360) 694-3040
(360) 735-7484
Mailing address
1104 MAIN ST, SUITE #440, VANCOUVER, WA 98660-2999
(360) 694-3040
(360) 735-7484
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
L0895
OR
1041C0700X
Clinical Social Worker
Primary
LW00005079
WA
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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