NICHOLAS FISH R-AAC, CPC
NPI 1407619158
Peer Specialist in Longview, WA
- Individual
- Male
- Peer Specialist
About NICHOLAS FISH
This page provides the complete NPI Profile along with additional information for Nicholas Fish, a provider established in Longview, Washington with a medical specialization in Peer Specialist. The healthcare provider is registered in the NPI registry with number 1407619158 assigned on February 2024. The practitioner's primary taxonomy code is 175T00000X with license number CG61510612 (WA). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1407619158 Verify this NPI
- Provider Name
- NICHOLAS FISH R-AAC, CPC
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1131 BROADWAY ST LONGVIEW, WA 98632
- Location Phone
- (360) 998-3050
- Location Fax
- (360) 998-3051
- Mailing Address
- PO BOX 2394 LONGVIEW, WA 98632
- Mailing Phone
- (360) 200-5419
- Mailing Fax
- (360) 200-6736
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-05-2024
- Last Update Date
- 02-05-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Peer Specialist
- Taxonomy Code
- 175T00000X
- Type
- Other Service Providers
- License No.
- CG61510612
- License State
- WA
- Taxonomy Description
- Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1407619158, enumerated as an "individual" on February 05, 2024.
The provider is located at 1131 BROADWAY ST LONGVIEW, WA 98632 and the phone number is (360) 998-3050.
Peer Specialist with taxonomy code 175T00000X.
