Individual
DAVID RICHARD BALDWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP00006153
Contact information
Practice address
230 EAST STATE STREET, MOSSYROCK, WA 98564
(360) 983-3257
Mailing address
P.O BOX 67, EAST STATE STREET, MOSSYROCK, WA 98564
(360) 983-3227
(360) 983-3289
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006153
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1991983
—
WA
Enumeration date
09/20/2017
Last updated
09/20/2017
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