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Individual

JOHN LAWRENCE CHURCHWARD SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDP

Contact information

Practice address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-3545
Mailing address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-3545

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60437986
101YA0400X
Addiction (Substance Use Disorder) Counselor

Other

Enumeration date
12/17/2018
Last updated
09/27/2019
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