AQUA PSYCH PLLC NPI 1194556407

NPI Information

  • NPI: 1194556407
  • Provider Name: AQUA PSYCH PLLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Doing Business As: AQUA PSYCH
  • Address: 4400 NE 77TH AVE STE 275
    VANCOUVER, WA
    ZIP 98662
  • Phone: (564) 225-2625

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NPI Details

AQUA PSYCH PLLC is a psychiatric/mental health nurse practitioner in Vancouver, WA. AQUA PSYCH PLLC NPI is 1194556407. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Aqua Psych.

The provider's business location address is:

4400 NE 77TH AVE STE 275
VANCOUVER, WA
ZIP 98662-857
Phone: (564) 225-2625

The provider's authorized official is Jason Cheek .
The authorized official title is Psychiatric Nurse Practitioner and has the following contact phone number (564) 225-2625.

The enumeration date for this NPI number is 8/8/2024 and was last updated on 8/8/2024.

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

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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