Individual provider · Type 1 NPI

Michael A. Tisdale, CP00003857

Addiction (Substance Use Disorder) Counselor · Elma, WA

NPI number 1831414796 Active

Practice location

308 E. Young St.
Elma, WA 98541

Mailing address

PO Box 477
Elma, WA 98541-0477

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCP00003857 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1831414796

Michael A. Tisdale, CP00003857's National Provider Identifier is 1831414796, issued on Apr 5, 2010. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Elma, WA. The record was last updated on Apr 5, 2010.