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Individual
JESSE WAYNE COBURN
Active
Individual
JESSE WAYNE COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LSCW, CADC II, SUDP
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
19-10-32
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP61374175
WA
1041C0700X
Clinical Social Worker
L10830
OR
1041C0700X
Clinical Social Worker
L18030
OR
1041C0700X
Clinical Social Worker
Primary
LW61327515
WA
Other
Enumeration date
05/23/2019
Last updated
06/24/2026
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