Healthcare Provider Details

I. General information

NPI: 1467379255
Provider Name (Legal Business Name): ERRIAEL ROSHELL MITCHELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 NW BUCKLIN HILL RD STE 215
SILVERDALE WA
98383-8363
US

IV. Provider business mailing address

5964 CHINOOK PASS ST APT 5
BREMERTON WA
98312-2084
US

V. Phone/Fax

Practice location:
  • Phone: 360-337-2222
  • Fax: 360-850-0211
Mailing address:
  • Phone: 208-501-6609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberCBT.CB.70143990
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: