Organization
PSYCHE WELLBEING
Active
Other names
Psyche Wellbeing
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOVEL BROQUEZA DNP (PRESIDENT)
(360) 903-1829
Entity
Organization
Contact information
Practice address
201 NE PARK PLAZA DR STE 200, VANCOUVER, WA 98684-5871
(360) 903-1829
(360) 991-0337
Mailing address
PO BOX 699, CAMAS, WA 98607-0699
(360) 903-1829
(360) 991-0337
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598019697
PROVIDER'S NPI (PRESIDENT/OWNER OF PSYCHE WELLBEING)
IL
Enumeration date
09/03/2024
Last updated
02/07/2025
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