Mikaela Davison
Individual provider Active NPI Mental Health Counselor · Buckley, WA
NPI 1497300651 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1497300651
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- MC61528653 (WA)
- Practice address
- 159 South Cedar St
Buckley, WA 98321 - Phone
- (503) 426-6335
- NPI assigned
- Aug 5, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC61528653 | WA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC61528653 | WA | Yes |
Addresses
Primary practice location
159 South Cedar St
Buckley, WA 98321
Mailing address
PO Box 762
Buckley, WA 98321-0762
Other providers in Buckley, WA
- City of Buckley
- CLB Pharmaceutical Resources Inc
- Jennifer Cochrane-Nicolls
- Clare Elizabeth Coetzer
- Anna Marie Corey
- Beth J. Decarteret
- Tyler Drew Delmonte
- Danette Louise Delo
- Judy Ann Desoto
- Joanne Elizabeth Earle
All providers in Buckley, WA · Mental Health Counselor in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.