Healthcare Provider Details

I. General information

NPI: 1396250460
Provider Name (Legal Business Name): ALISHA MARIE BEEHLER CDPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2017
Last Update Date: 12/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 NE 117TH ST STE 101
VANCOUVER WA
98686-4022
US

IV. Provider business mailing address

11205 NE 49TH ST
VANCOUVER WA
98682-6249
US

V. Phone/Fax

Practice location:
  • Phone: 360-566-9112
  • Fax: 360-566-9133
Mailing address:
  • Phone: 360-553-2600
  • Fax: 360-566-9113

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number60647192
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: