Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stacy Raeann Wirkkala, SUDPT

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1144973223

Stacy Raeann Wirkkala, SUDPT is an Addiction (Substance Use Disorder) Counselor in Kelso, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2022

Practice location Address checks out

404 W Main St
Kelso, WA 98626-1118
Phone: (360) 423-2806
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence CO61077791 (WA)

Record details

NPI number1144973223
Entity typeIndividual (Type 1)
GenderFemale
Credentials SUDPT
Sole proprietorYes
NPI enumeratedJanuary 30, 2022
Last updated in NPPESJuly 1, 2023
Certification dateJune 30, 2023

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