Individual
TISE AFUOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA, SUDPT
Contact information
Practice address
748 14TH AVE, LONGVIEW, WA 98632-2315
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
60944303
WA
175T00000X
Peer Specialist
CG61158364
WA
175T00000X
Peer Specialist
Primary
PR70152743
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2168939
—
WA
Enumeration date
12/16/2020
Last updated
03/31/2026
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