Individual
ROGER JONATHAN GAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2212 S JACKSON ST, SEATTLE, WA 98144-2591
(206) 322-2387
Mailing address
1305 TACOMA AVE S STE 305, TACOMA, WA 98402-1903
(253) 396-5827
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
12/23/2019
Last updated
03/23/2026
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