Individual
JASON ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5431 N GOVERNMENT WAY, COEUR D ALENE, ID 83815-5073
(208) 667-7603
Mailing address
5431 N GOVERNMENT WAY, COEUR D ALENE, ID 83815-5073
(208) 667-7603
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
JLA10-12
OR
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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