Provider Demographics
NPI:1063027068
Name:STRICKLER, COLLETTE A
Entity Type:Individual
Prefix:
First Name:COLLETTE
Middle Name:A
Last Name:STRICKLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21012 NE KRISTEN CIR
Mailing Address - Street 2:
Mailing Address - City:BRUSH PRAIRIE
Mailing Address - State:WA
Mailing Address - Zip Code:98606-8916
Mailing Address - Country:US
Mailing Address - Phone:360-896-2022
Mailing Address - Fax:
Practice Address - Street 1:9901 NE 7TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98685-4523
Practice Address - Country:US
Practice Address - Phone:360-571-2432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAWDL6TZ85413B106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician