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Individual

DR. GARETH JOHN PENTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, ARNP, PMHNP-BC

Contact information

Practice address
880 11TH AVE STE 201, LONGVIEW, WA 98632-2402
(360) 559-3456
Mailing address
880 11TH AVE STE 201, LONGVIEW, WA 98632-2402

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
ARNP.AP.61079484-NP
WA

Other

Enumeration date
06/05/2020
Last updated
10/12/2022
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