Individual
KASSIE GEILENFELDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7254
(360) 993-3000
Mailing address
13604 SE 20TH CIR, VANCOUVER, WA 98683-7112
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61021583
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/20/2019
Last updated
09/03/2021
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