Provider Demographics
NPI:1548411275
Name:LEMMON, GRETCHEN C (PSYD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:C
Last Name:LEMMON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61622
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98666-1622
Mailing Address - Country:US
Mailing Address - Phone:503-740-7463
Mailing Address - Fax:
Practice Address - Street 1:1104 MAIN ST STE 550A
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2955
Practice Address - Country:US
Practice Address - Phone:503-740-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60145665103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical