Individual
JAMES THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CP00004542
Contact information
Practice address
2700 SIMPSON AVENUE, SUITE 101, ABERDEEN, WA 98520
(360) 612-0012
(360) 218-5945
Mailing address
921 14TH AVENUE, LONGVIEW, WA 98632
(360) 423-0203
(360) 577-0269
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00004542
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00004542
WA
101YM0800X
Mental Health Counselor
00004542
WA
Other
Enumeration date
01/25/2017
Last updated
08/11/2020
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