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General NPI Number Information
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NPI Number | 1700538030
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Entity Type | Individual
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Provider Name | ALISA WOLF LMHCA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2022
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Last Update Date | 12/31/2024
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Provider Practice Location Address
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Address Line | 16701 SE MCGILLIVRAY BLVD # 140
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City | VANCOUVER
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State | WA
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Zip | 98683-3485
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Country | US
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Telephone | 503-683-1636
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Fax |
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Provider Business Mailing Address
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Address Line | 18600 NE 215TH PL
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City | BRUSH PRAIRIE
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State | WA
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Zip | 98606-9007
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Country | US
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Telephone | 303-257-8833
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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 | LH61545422
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License Number State | WA
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