Basic Information
Provider Information
NPI: 1073855995
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MORRISON
FirstName: STEVEN
MiddleName: MICHAEL
NamePrefix: MR.
NameSuffix:  
Credential: CDP, MHP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 1337
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986661337
CountryCode: US
TelephoneNumber: 3607373523
FaxNumber: 3603978494
Practice Location
Address1: 6326 N.E. FOURTH PLAIN BLVD
Address2:  
City: VANCOUVER
State: WA
PostalCode: 986661337
CountryCode: US
TelephoneNumber: 3607373523
FaxNumber: 3603978494
Other Information
ProviderEnumerationDate: 03/18/2013
LastUpdateDate: 04/04/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400XCP60214192WAN Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
101YM0800XMC60857070WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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