Individual
MR. ELLERY HOLESAPPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3753
(360) 397-8246
(360) 397-8458
Mailing address
PO BOX 1678, VANCOUVER, WA 98668-1678
(360) 397-8246
(360) 397-8458
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60494014
WA
Other
Enumeration date
02/18/2015
Last updated
02/18/2015
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