Individual
HAROLD JAMES LUNDGREN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901 N LIDGERWOOD ST STE 115, SPOKANE, WA 99208-1122
(509) 838-4651
Mailing address
107 S DIVISION ST, SPOKANE, WA 99202-1510
(509) 838-4651
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60531421
WA
175T00000X
Peer Specialist
Primary
CG60531421
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2114445
—
WA
Enumeration date
11/09/2018
Last updated
02/05/2020
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