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Individual
DUANE SIVANISH
Active
Individual
DUANE SIVANISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60670638
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61128453
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO60670638
STATE
WA
Enumeration date
04/15/2019
Last updated
06/23/2021
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