Individual
CARON ELIZABETH WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
825 E 5TH ST, PORT ANGELES, WA 98362-3818
(360) 477-4790
(360) 477-4802
Mailing address
825 E 5TH ST, PORT ANGELES, WA 98362-3818
(360) 477-4790
(360) 477-4802
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60696850
WA
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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