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Individual

JOHANNA KATHERINE CHEVRIER ELLIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW, MSW

Contact information

Practice address
9300 NE OAK VIEW DR, VANCOUVER, WA 98662-6157
(360) 567-2211
Mailing address
4701 NE 72ND AVE APT T205, VANCOUVER, WA 98661-8182
(909) 380-4127

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
1041C0700X
Clinical Social Worker
Primary
LW61572473
WA
175T00000X
Peer Specialist

Other

Enumeration date
07/12/2019
Last updated
01/07/2025
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