Healthcare Provider Details

I. General information

NPI: 1699985903
Provider Name (Legal Business Name): CHANDLER E STEVENSON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/19/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 NE 134TH ST STE 301
VANCOUVER WA
98686-3029
US

IV. Provider business mailing address

PO BOX 2949
SOLDOTNA AK
99669-2949
US

V. Phone/Fax

Practice location:
  • Phone: 360-882-2778
  • Fax:
Mailing address:
  • Phone: 907-260-7300
  • Fax: 907-260-7301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number681
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60859891
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number909
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberC7246
License Number StateOR
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number142
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: