MICHAEL A TISDALE

ELMA, WA
NPI1831414796
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP00003857)
Enumeration Date2010-04-05
Last Update Date2010-04-05
Business Address
Mr. MICHAEL A TISDALE CP00003857
308 E. YOUNG ST.
ELMA, WA 98541
Phone number: 360-482-2674
Mailing Address
Mr. MICHAEL A TISDALE CP00003857
PO BOX 477
ELMA, WA 98541-0477
Phone number: 360-482-2674
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