Provider Demographics
NPI:1255001426
Name:KESSLER, ELIZABETH MEGAN (SUDPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MEGAN
Last Name:KESSLER
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1931
Mailing Address - Street 2:
Mailing Address - City:EATONVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98328-1931
Mailing Address - Country:US
Mailing Address - Phone:206-636-3049
Mailing Address - Fax:
Practice Address - Street 1:21120 MERIDIAN E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-8254
Practice Address - Country:US
Practice Address - Phone:253-285-4750
Practice Address - Fax:253-627-8387
Is Sole Proprietor?:No
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)