Individual
STEPHEN CAVENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
1007 KOALA DR., OMAK, WA 98841
(509) 826-6191
(509) 826-8416
Mailing address
1007 KOALA DR., OMAK, WA 98841
(509) 826-6191
(509) 826-8416
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60214880
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP60214880
CHEMICAL DEPENDENCY PROFESSIONAL LICENSE
WA
Enumeration date
05/15/2013
Last updated
05/15/2013
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