Steven Bruce Gooding, CDP

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · La Conner, WA

NPI 1013363886 · NPPES record last updated Jan 11, 2018

Key facts

NPI
1013363886
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CP60617801 (WA)
Practice address
17400 Reservation Rd.
La Conner, WA 98257
Phone
(360) 588-2730
Fax
(360) 848-5250
NPI assigned
May 10, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CP60617801WAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP60617801 WA Yes

Addresses

Primary practice location

17400 Reservation Rd.
La Conner, WA 98257

Mailing address

PO Box 683
Swinomish Indian Tribal Community Chemical Dependency
La Conner, WA 98257
Phone (360) 848-8437

Other providers in La Conner, WA

All providers in La Conner, WA · Addiction (Substance Use Disorder) Counselor in Washington

Sources for this page

Verify at the official NPI Registry.