IndividualActive
Michael Tisdale, CP00003857
NPI 1831414796 · Addiction (Substance Use Disorder) Counselor · Elma, WA
Provider details
- NPI number
- 1831414796
- Entity type
- Individual
- Primary specialty
- Addiction (Substance Use Disorder) CounselorBehavioral Health & Social Service Providers
- Credential
- CP00003857
- Sex
- Male
- Sole proprietor
- No
- License
- CP00003857 (WA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(83/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
308 E. Young St.
Elma, WA 98541
Phone: (360) 482-2674
Street-level locationGet directions
Mailing address
Po Box 477
Elma, WA 98541-0477
Registry dates
- Enumerated
- 2010-04-05
- Last updated
- 2010-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.