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General NPI Number Information
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NPI Number | 1427416882
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Entity Type | Individual
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Provider Name | COLLEEN MARIE CHESNUT
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Gender | Female
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Dates
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Enumeration Date | 02/01/2016
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 231 SE BARRINGTON DR STE 203
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City | OAK HARBOR
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State | WA
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Zip | 98277-3200
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Country | US
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Telephone | 360-672-5918
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Fax |
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Provider Business Mailing Address
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Address Line | 231 SE BARRINGTON DR STE 203
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City | OAK HARBOR
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State | WA
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Zip | 98277-3200
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Country | US
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Telephone | 360-204-0022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CAAR.CG.60619608
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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