Provider Demographics
NPI:1417114869
Name:GRIFFETH, DEANNA (RC, CDP)
Entity Type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:GRIFFETH
Suffix:
Gender:F
Credentials:RC, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 MILLER RD NE
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-3417
Mailing Address - Country:US
Mailing Address - Phone:360-297-9673
Mailing Address - Fax:360-297-9678
Practice Address - Street 1:32014 LITTLE BOSTON RD NE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:WA
Practice Address - Zip Code:98346-9734
Practice Address - Country:US
Practice Address - Phone:360-297-9673
Practice Address - Fax:360-297-9678
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00003969101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARC00036335OtherREGISTERED COUNSELOR
WACP00003969OtherCHEMICAL DEPENDENCY PROFESSIONAL