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Ivan David Nelson, CPC
Peer Specialist in Longview, Washington
NPI 1033686795

Ivan David Nelson is a Peer Specialist based in Longview, WA. Ivan David Nelson practices in Longview, WA and has the professional credentials of CPC. The NPI Number for Ivan David Nelson is 1033686795 and holds a License No. (Washington).

The current practice location address for Ivan David Nelson is 748 14Th Avenue, Longview, WA and can be reached out via phone at 360-200-5419 and via fax at 360-200-6736. You can also correspond with Ivan David Nelson through the mailing address at PO BOX 2394, LONGVIEW, WA - 98632 (mailing address contact number: 360-200-5419).

Location: 748 14Th Avenue, Longview, WA, 98632
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033686795
Provider Name
Ivan David Nelson
Credential
CPC
Provider Entity Type
Individual
Gender
Male
Address
748 14Th Avenue, Longview, WA, 98632
Phone Number
360-200-5419
Fax Number
360-200-6736
Provider Enumeration Date
10/30/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2155913 05 WA
institution
Provider Business Practice Location Address Details
Address
748 14Th Avenue
City
Longview
State
Washington
Zip
98632
Phone Number
360-200-5419
Fax Number
360-200-6736
person
Provider Business Mailing Address Details
Address
748 14Th Avenue
City
Longview
State
Washington
Zip
98632
Phone Number
360-200-5419
Fax Number
360-200-6736
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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