Individual
CHRISTOPHER TODD LAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH,CDP
Contact information
Practice address
7700 NE 26TH AVE, VANCOUVER, WA 98665-0672
(360) 397-8228
(360) 397-8259
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 397-8228
(360) 397-8259
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00004949
WA
Other
Enumeration date
05/25/2010
Last updated
10/13/2017
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