Irvine, Autumn

Irvine, Autumn is an individual health care provider with primary practice located at 404 W Main St , Kelso WA 98626-1118. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Counselor. Behavioral Health & Social Service Providers / Counselor is her primary health care specialty. Irvine, Autumn can be contacted via phone (360) 423-2806.

Contact Information

Primary practice address
404 W Main St Kelso WA 98626-1118
Phone: (360) 423-2806
Fax: (360) 423-5128
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CP 60188084 Washington
Behavioral Health & Social Service Providers / Counselor 101Y00000X CG61313331 Washington

Profile Details

NPI number 1871029140
LBN Legal business name Irvine, Autumn
Credentials SUDP, CAAR
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2017
Last updated Feb 28th, 2023 - about 3 years 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.

Request for update

Popular Providers