Peter August Joseph

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

NPI 1497988679 · NPPES record last updated Sep 3, 2009

Key facts

NPI
1497988679
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
CP 00001117 (WA)
Practice address
6750 Mission Rd
Everson, WA 98247-9749
Phone
(360) 966-7704
Fax
(360) 966-4225
NPI assigned
Sep 3, 2009
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
CP 00001117WAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CP 00001117 WA Yes

Addresses

Primary practice location

6750 Mission Rd
Everson, WA 98247-9749

Mailing address

PO Box 157
Deming, WA 98244-0157
Phone (360) 966-7704

Other providers in Everson, WA

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

Sources for this page

Verify at the official NPI Registry.