Individual
MRS. BONNIE JANE WEDEKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
400 E EVERGREEN BLVD, SUITE 302, VANCOUVER, WA 98660-3331
(360) 696-1137
Mailing address
3718 SE 169TH CT, VANCOUVER, WA 98683-9400
(360) 696-1137
(360) 896-7269
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1455
OR
Other
Enumeration date
08/13/2006
Last updated
07/08/2007
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