Individual
MR. ISMAEL BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
720 W COURT ST, SUITE 8 NUEVA ESPERANZA, PASCO, WA 99301
(509) 545-6506
(509) 546-0520
Mailing address
PO BOX 1323, PASCO, WA 99301
(509) 547-2204
(509) 542-8836
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
RC00046735
WA
Other
Enumeration date
04/13/2007
Last updated
07/08/2007
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