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General NPI Number Information
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NPI Number | 1801557665
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Entity Type | Individual
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Provider Name | ELISA MANAPAT FU MSW, LICSWA
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Gender | Female
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 6400 NE HIGHWAY 99 STE G1063
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City | VANCOUVER
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State | WA
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Zip | 98665-8799
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Country | US
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Telephone | 360-524-4833
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Fax | 360-326-9691
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Provider Business Mailing Address
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Address Line | 6400 NE HIGHWAY 99 STE G1063
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City | VANCOUVER
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State | WA
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Zip | 98665-8799
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Country | US
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Telephone | 360-524-4833
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Fax | 360-326-9691
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 61431858
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License Number State | WA
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