Basic Information
| Provider Information | |||||||||
| NPI: | 1730325218 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROBERTSON-ABRUDAN | ||||||||
| FirstName: | CHERNESE | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | M.S | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2569 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982130569 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1021 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982011405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4254935814 | ||||||||
| FaxNumber: | 4254935801 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/05/2009 | ||||||||
| LastUpdateDate: | 08/20/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 101Y00000X | 60068650 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.