Healthcare Provider Details

I. General information

NPI: 1548172075
Provider Name (Legal Business Name): ALLISON LONG, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 MAIN ST STE 301
VANCOUVER WA
98660-3404
US

IV. Provider business mailing address

601 MAIN ST STE 301
VANCOUVER WA
98660-3404
US

V. Phone/Fax

Practice location:
  • Phone: 360-329-4696
  • Fax: 360-492-4401
Mailing address:
  • Phone: 360-329-4696
  • Fax: 360-492-4401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ALLISON LONG
Title or Position: OWNER
Credential: LICSW
Phone: 360-329-4696