Individual
ISABELL CRUZ-CHISHOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 14TH AVENUE, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
C060723785
WA
101Y00000X
Counselor
Primary
CG60844747
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2135113
—
WA
Enumeration date
11/27/2018
Last updated
05/04/2021
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