Individual
JESSE DANIEL GONZALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 8TH ST, HOQUIAM, WA 98550-3522
(360) 532-4357
(360) 538-0124
Mailing address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
(360) 423-2311
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
60806509
WA
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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