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Organization

COLONIAL CLINIC II, LLC

Active
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Organization

COLONIAL CLINIC II, LLC

Active
Other names
Colonial Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL J. COLYAR MA,CDP,NCACII,SAP (EXECUTIVE DIRECTOR)
(509) 327-9831
Entity
Organization

Contact information

Practice address
910 N WASHINGTON ST, SUITE 210, SPOKANE, WA 99201-2202
(509) 327-9831
(509) 327-9857
Mailing address
910 N WASHINGTON ST, SUITE 210, SPOKANE, WA 99201-2202
(509) 327-9831
(509) 327-9857

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32025500
CHEMICAL DEPENDENCY TREAT
WA
01
—
J0HY6W00
ONE HLTH. PORT ID.
WA
Enumeration date
10/28/2005
Last updated
03/15/2012
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