Individual
JERED JAMES CARTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUD
Contact information
Practice address
2280 SR 821, YAKIMA, WA 98901
(509) 457-0990
Mailing address
PO BOX 217, SELAH, WA 98942-0217
(509) 457-0990
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60983949
WA
Other
Enumeration date
08/02/2018
Last updated
07/02/2021
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