Individual
ELIJAWAN ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
58147 COLUMBIA RIVER HWY, SUITE C, SAINT HELENS, OR 97051-6226
(503) 396-5322
(503) 410-5678
Mailing address
58147 COLUMBIA RIVER HWY, SUITE C, SAINT HELENS, OR 97051-6226
(503) 396-5322
(503) 410-5678
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/14/2017
Last updated
03/14/2017
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