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NPI Code Detail

MEDICARE: MRS. EMILY NELSON CDP

MEDICARE: MRS. EMILY NELSON CDP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor60115792WA

General Provider Information

NPI Number : 1144772682
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY NELSON CDP
Provider Business Mailing Address
First Line : 820 S 4TH STREET LOOP
Second Line :
City : SELAH
State : WA
Zip : 98942-1924
Country : US
Telephone Number : 509-469-9366
Fax Number : 509-469-9926
Provider Business Practice Location Address
First Line : 315 N 2ND ST
Second Line :
City : YAKIMA
State : WA
Zip : 98901-2334
Country : US
Telephone Number : 509-469-9366
Fax Number : 509-469-9926
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2016
Last Update Date : 11/01/2016

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Directions to “ MRS. EMILY NELSON CDP” Practice Location

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