Individual
MICHELLE M CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4774
Mailing address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4776
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60114318
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2172951
—
WA
Enumeration date
10/26/2018
Last updated
05/11/2022
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