Individual
JASON CODY MECHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2269 OYSTER AVE, KETCHIKAN, AK 99901-9539
(425) 737-5076
(907) 202-8684
Mailing address
PO BOX 7475, KETCHIKAN, AK 99901-2475
(425) 737-5076
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17073638
—
AK
05
—
1713721
—
AK
Enumeration date
04/08/2021
Last updated
04/08/2021
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