Individual
AMBER DELAGRANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
2232 S SILVER LAKE RD, CASTLE ROCK, WA 98611-8021
(360) 274-3262
(360) 274-3345
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 636-3892
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60476132
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084534
—
WA
Enumeration date
05/15/2015
Last updated
03/13/2024
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