Individual provider · Type 1 NPI
Corliss Wentworth, COUNSELOR
Addiction (Substance Use Disorder) Counselor · Vancouver, WA
NPI number
1669691176
Active
Practice location
1601 E Fourth Plain Blvd # 101
Vancouver, WA 98661-3713
Fax (360) 397-8450
Mailing address
2009 NE 117th St, 101
Vancouver, WA 98686-4022
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | CP00005457 (WA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1669691176
Corliss Wentworth, COUNSELOR's National Provider Identifier is 1669691176, issued on Apr 24, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Vancouver, WA. The record was last updated on Mar 25, 2019.