Provider Demographics
NPI:1447651625
Name:ELAINE PICHETTE NP & ASSOCIATES PLLC
Entity type:Organization
Organization Name:ELAINE PICHETTE NP & ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:CONSANDINE
Authorized Official - Last Name:PICHETTE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-528-0563
Mailing Address - Street 1:1000 KRESKY AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-3700
Mailing Address - Country:US
Mailing Address - Phone:360-528-0563
Mailing Address - Fax:360-858-7047
Practice Address - Street 1:1000 KRESKY AVE
Practice Address - Street 2:SUITE G
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-3700
Practice Address - Country:US
Practice Address - Phone:360-528-0563
Practice Address - Fax:360-858-7047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603419819261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)