Individual
MR. BRUCE DOUGLAS WASHBURNE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LISW
Contact information
Practice address
1501 SAN PEDRO DR SE, ALBUQUERQUE, NM 87108-5153
(505) 265-1711
(505) 256-6414
Mailing address
424 WELLESLEY DR SE, ALBUQUERQUE, NM 87106-1424
(505) 265-3218
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
I-0957
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I-0957
SOCIAL WORK LICENSE
NM
Enumeration date
03/30/2006
Last updated
07/08/2007
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