Basic Information
| Provider Information | |||||||||
| NPI: | 1619308426 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BREHM | ||||||||
| FirstName: | ASHLYN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2611B PEACH CT | ||||||||
| Address2: | |||||||||
| City: | PORT ANGELES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983631361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9513260316 | ||||||||
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| Practice Location | |||||||||
| Address1: | 231 SE BARRINGTON DR. SUITE 203 | ||||||||
| Address2: | |||||||||
| City: | OAK HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98277 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662400808 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2013 | ||||||||
| LastUpdateDate: | 07/25/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103K00000X | Y | Behavioral Health & Social Service Providers | Behavioral Analyst | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 101YM0800X | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.