Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
STACY RAEANN WIRKKALA, SUDPT
Active Sole ProprietorSTACY RAEANN WIRKKALA, SUDPT is a Addiction (Substance Use Disorder) Counselor healthcare provider located in KELSO, Washington. NPI 1144973223 is currently active in the NPPES registry. Verify at CMS.
Addiction (Substance Use Disorder) Counselor · KELSO, WA
Registration Details
- NPI Number
- 1144973223
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 30, 2022 (4.39237087686 yrs)
- Last Updated
- Jul 1, 2023
- License
-
CO61077791 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
404 W MAIN STKELSO, WA, 986261118Browse WA providers · Browse ZIP 98626
- Phone
- 3604232806
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
Other Addiction (Substance Use Disorder) Counselor Providers in KELSO, WA
| Name | Credential | NPI |
|---|---|---|
| MR. LARRY JAMES TEDDER | CDP | 1376823526 |
| GREGORY ERNEST ERBES | SUDP | 1629328612 |
| RAMA MITCHELL JR. | SUDP | 1609266717 |
| MICHELLE BUCKHOLZ | SUDP | 1215323977 |
| DEBORAH SMITH | — | 1083092548 |
| CATHY LUDAHL | CDP | 1073982880 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.