Individual ProviderDestiny C FaulconerCounselorBehavioral Health & Social Service ProvidersPractice Address1601 E Fourth Plain Blvd Bldg 17, Vancouver, WA 98661-3717(360) 397-8484PECOS EnrollmentBased on the most recent information from CMS, provider Destiny C Faulconer does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:04 AM.Profile DetailsProvider ID1467095877Provider TypeIndividualFull NameFaulconer, Destiny CGenderFemaleSole ProprietorNoEnumeration Date10/18/2019Last Updated10/18/2019Contact InformationPractice LocationPractice Address1601 E Fourth Plain Blvd Bldg 17, Vancouver, WA 98661-3717Phone(360) 397-8484Fax(360) 397-8494Mailing LocationMailing AddressPO Box 1845, Vancouver, WA 98668-1845PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer