Individual
JASON B JOHNSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
10215 214TH AVE E, BONNEY LAKE, WA 98391-3909
(253) 862-7374
(253) 862-0448
Mailing address
13807 69TH AVENUE CT E, PUYALLUP, WA 98373-8721
(253) 691-0398
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60288139
WA
Other
Enumeration date
12/17/2018
Last updated
12/17/2018
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