Individual
ELLIEANNA RENEE CAVAZOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4526 FEDERAL AVE, EVERETT, WA 98203-2132
(425) 349-6200
Mailing address
4526 FEDERAL AVE, EVERETT, WA 98203-2132
(425) 349-6200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
101Y00000X70088618
WA
101Y00000X
Counselor
CG70088618
WA
175T00000X
Peer Specialist
Primary
175T00000X70069888
WA
175T00000X
Peer Specialist
Primary
PE70069888
WA
Other
Enumeration date
01/15/2026
Last updated
02/13/2026
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