Individual
CONNOR TYSKIEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
11719 NE 95TH ST STE AD, VANCOUVER, WA 98682-2444
(360) 984-5511
Mailing address
11719 NE 95TH ST STE AD, VANCOUVER, WA 98682-2444
(971) 712-9210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61621068
WA
Other
Enumeration date
04/08/2025
Last updated
10/20/2025
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