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General NPI Number Information
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NPI Number | 1508772757
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Entity Type | Individual
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Provider Name | CHERYL VANCLEEF
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 21810 NE 37TH AVE
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City | RIDGEFIELD
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State | WA
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Zip | 98642-7747
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Country | US
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Telephone | 360-687-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 7 W PINE LN
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City | LONGVIEW
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State | WA
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Zip | 98632-5189
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Country | US
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Telephone | 360-751-6307
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDPT.CO.61593042
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License Number State | WA
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