Individual
ELISA RENEE WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1116 14TH AVE, LONGVIEW, WA 98632-3017
(360) 261-6930
Mailing address
1116 14TH AVE, LONGVIEW, WA 98632-3017
(360) 261-6930
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1942840160
WA
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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