Individual
DAVID JOHN STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
Mailing address
408 NW 5TH AVE, KELSO, WA 98626-1127
(208) 353-4964
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2013
Last updated
08/21/2013
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