Afuola, Tise
Afuola, Tise is an individual health care provider with primary practice located at 748 14Th Ave , Longview WA 98632-2315. He recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as his primary health care specialty. Afuola, Tise can be contacted via phone (360) 200-5419.Contact Information
Primary practice address
748 14Th Ave
Longview WA 98632-2315
Phone: (360) 200-5419
Fax: (360) 200-6736
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X | PR70152743 | Washington |
| Other Service Providers / Peer Specialist | 175T00000X | CG61158364 | Washington |
Profile Details
| NPI number | 1992391742 |
|---|---|
| LBN Legal business name | Afuola, Tise |
| Credentials | AA, SUDPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 16th, 2020 |
| Last updated | Mar 31st, 2026 - about 7 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1992391742 | NPPES |
| Washington | MEDICAID | 2168939 |
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