Individual
ELISE BIRDSONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
2610 WETMORE AVE, EVERETT, WA 98201-2927
(425) 258-5270
Mailing address
2610 WETMORE AVE, EVERETT, WA 98201-2927
(425) 258-5270
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60736213
CDPT CERTIFICATION
—
Enumeration date
04/04/2017
Last updated
04/10/2017
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