Individual
ASHLEY REYNVANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1616 S. GOLD ST. #4, CENTRALIA, WA 98531-0001
(360) 807-4929
(360) 807-4160
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-2315
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60915318
WA
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2136930
—
WA
Enumeration date
11/16/2018
Last updated
05/04/2021
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