Individual
PHILLIP CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
3507 NE 127TH AVE, VANCOUVER, WA 98682-7657
(360) 513-9049
Mailing address
3507 NE 127TH AVE, VANCOUVER, WA 98682-7657
(360) 513-9049
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60638054
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101YA400X
COUNSELOR ADDICTION
OR
Enumeration date
10/14/2016
Last updated
08/12/2020
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