Tise Afuola, AA, SUDPT – Peer Specialist

Key facts

NPI: 1992391742
Entity type: Individual (NPI type 1)
Primary specialty: Peer Specialist 175T00000X
License: PR70152743 (WA)
Practice address: 748 14TH Ave
Longview, WA 98632-2315
Phone: (360) 200-5419
Fax: (360) 200-6736
NPI assigned: Dec 16, 2020
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Core Health Mental Health Clinic/Center (Including Community Mental Health Center) · Longview, WA · NPI 1639693781

NPD (past)

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Associate of Arts

State licenses

License	State	Type	Specialty
CG61158364	WA	MD	Peer Specialist
PR70152743	WA	MD	Peer Specialist

Practice roles

Organization	Specialty	Status	New patients
Core Health		Past since Dec 22, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Peer Specialist	175T00000X	PR70152743	WA	Yes
Peer Specialist	175T00000X	CG61158364	WA

Addresses

Primary practice location

748 14TH Ave
Longview, WA 98632-2315

Mailing address

PO Box 2394
Longview, WA 98632-8455
Phone (360) 200-5419

Other identifiers

Identifier	Type	State	Issuer
2168939	Medicaid	WA

Other providers in Longview, WA

All providers in Longview, WA · Peer Specialist in Washington

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 31, 2026. 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.

Verify at the official NPI Registry.