Individual
JESUS MACIAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CG60693090
Contact information
Practice address
510 W 1ST AVE, TOPPENISH, WA 98948-1564
(509) 865-3127
Mailing address
510 W 1ST AVE, TOPPENISH, WA 98948-1564
(509) 865-3127
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
10/11/2016
Last updated
12/21/2021
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