Provider Demographics
NPI:1558031443
Name:RAMEY, CHELISE MARIE
Entity Type:Individual
Prefix:
First Name:CHELISE
Middle Name:MARIE
Last Name:RAMEY
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:PO BOX 245
Mailing Address - Street 2:
Mailing Address - City:TRACYTON
Mailing Address - State:WA
Mailing Address - Zip Code:98393-0245
Mailing Address - Country:US
Mailing Address - Phone:360-908-1262
Mailing Address - Fax:
Practice Address - Street 1:661 TAYLOR ST
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-4300
Practice Address - Country:US
Practice Address - Phone:360-337-4625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61158399101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)