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Individual
JEFFERY BENNETT RAY
Active
Individual
JEFFERY BENNETT RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO60538724
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CO 60538724
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60671924
WA
Other
Enumeration date
04/13/2017
Last updated
05/13/2025
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