Individual
MS. CANDI DYAN PRESCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CP60757485
Contact information
Practice address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 350-4010
Mailing address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 350-4010
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60757485
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33-0652655
—
CA
05
—
33-0652655
—
WA
Enumeration date
03/27/2019
Last updated
03/27/2019
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