Individual
JEFFREY WOLFANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 S 4TH AVE, YAKIMA, WA 98902-3546
(509) 493-3400
Mailing address
PO BOX 959, YAKIMA, WA 98907-0959
(509) 575-4084
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60124010
WA
101Y00000X
Counselor
RC PENDING
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00006405
WA
Other
Enumeration date
10/04/2007
Last updated
01/10/2012
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