DAYBREAK YOUTH SERVICES NPI 1003199712

NPI Information

NPI: 1003199712
Provider Name: DAYBREAK YOUTH SERVICES
Classification: Counselor - 101YM0800X
Specialization: Mental Health
Entity Type: Organization
Doing Business As: DAYBREAK VANCOUVER OUTPATIENT
Address: 11818 SE MILL PLAIN BLVD
SUITE 307
VANCOUVER, WA
ZIP 98684
Phone: (360) 750-9635

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NPI Details

DAYBREAK YOUTH SERVICES is a mental health counselor in Vancouver, WA. DAYBREAK YOUTH SERVICES NPI is 1003199712. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Daybreak Vancouver Outpatient.

The provider's business location address is:

11818 SE MILL PLAIN BLVD
SUITE 307
VANCOUVER, WA
ZIP 98684
Phone: (360) 750-9635
Fax: (360) 334-9541

The provider's authorized official is Thomas Russell .
The authorized official title is Ceo and has the following contact phone number (509) 444-7033.

The enumeration date for this NPI number is 9/20/2011 and was last updated on 9/22/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	06155400	WASHINGTON	No
2	251B00000X	Case Management		06155400	WASHINGTON	No
3	101YM0800X	Counselor	Mental Health	06155400	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2015313	MEDICAID	WASHINGTON
2	155400	OTHER	WASHINGTON	WA STATE DBHR

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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