Chanda Denise Allen, CDP

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Auburn, WA

NPI 1104397314 · NPPES record last updated Dec 16, 2018

Key facts

NPI
1104397314
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CP60171129 (WA)
Practice address
721 45TH St NE
Auburn, WA 98002-1303
Phone
(253) 289-6233
Fax
(253) 859-0789
NPI assigned
Dec 16, 2018
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CP60171129WAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YA0400X CP60171129 WA Yes

Addresses

Primary practice location

721 45TH St NE
Auburn, WA 98002-1303

Mailing address

721 45TH St NE Ste C
Auburn, WA 98002-1303
Phone (253) 289-6233

Other identifiers

IdentifierTypeStateIssuer
CP60171129OtherWACHEMICAL DEPENDENCY PROFESSIONAL

Other providers in Auburn, WA

All providers in Auburn, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

Verify at the official NPI Registry.