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Individual

DEVERIST RA-NIE DAUGHERTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9300 NE OAK VIEW DR, VANCOUVER, WA 98662-6157
(360) 567-2211
Mailing address
10918 NE 70TH CIR, VANCOUVER, WA 98662-4672
(503) 327-3082

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
09/17/2019
Last updated
09/17/2019
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