Individual
MR. JACOB RAYMOND DANIEL BOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS PSYCHOLOGY
Contact information
Practice address
10604 NE HIGHWAY 99, VANCOUVER, WA 98686-5613
(360) 644-1631
Mailing address
7106 NE 44TH CIR APT A, VANCOUVER, WA 98661-3688
(360) 600-9927
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/02/2023
Last updated
08/02/2023
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