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General NPI Number Information
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NPI Number | 1982236634
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Entity Type | Individual
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Provider Name | CARMEN LYNN BUTCHER-HOUSTON LSWAIC
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Gender | Female
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 11/27/2023
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Provider Practice Location Address
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Address Line | 1601 E FOURTH PLAIN BLVD # A152
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City | VANCOUVER
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State | WA
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Zip | 98661-3713
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Country | US
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Telephone | 360-397-8198
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Fax | 360-397-8276
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Provider Business Mailing Address
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Address Line | 300 SE 184TH AVE # C32
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City | VANCOUVER
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State | WA
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Zip | 98683-1928
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Country | US
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Telephone | 503-890-4656
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SC60947650
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License Number State | WA
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