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Mr. Michael A Tisdale, CP00003857
Addiction (Substance Use Disorder) Counselor in Elma, Washington
NPI 1831414796

Michael A Tisdale is an Addiction (Substance Use Disorder) Counselor based in Elma, WA and is specialized in Addiction (Substance Use Disorder). Michael A Tisdale practices in Elma, WA and has the professional credentials of CP00003857. The NPI Number for Michael A Tisdale is 1831414796 and holds a License No. CP00003857 (Washington).

The current practice location address for Michael A Tisdale is 308 E. Young St., Elma, WA and can be reached out via phone at 360-482-2674.

Location: 308 E. Young St., Elma, WA, 98541-0477
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1831414796
Provider Name
Michael A Tisdale
Credential
CP00003857
Provider Entity Type
Individual
Gender
Male
Address
308 E. Young St., Elma, WA, 98541-0477
Phone Number
360-482-2674
Fax Number
Provider Enumeration Date
04/05/2010
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
308 E. Young St.
City
Elma
State
Washington
Zip
98541
Phone Number
360-482-2674
Fax Number
person
Provider Business Mailing Address Details
Address
308 E. Young St.
City
Elma
State
Washington
Zip
98541
Phone Number
360-482-2674
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
CP00003857 (Washington)
Definition
Definition to come...
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