Individual
CORIE CANOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7369
(360) 993-3000
(360) 993-3047
Mailing address
PO BOX 1337, VANCOUVER, WA 98666-1337
(360) 993-3000
(360) 993-3047
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60875549
WA
Other
Enumeration date
11/22/2016
Last updated
12/02/2024
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