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Individual

ISAAC JOHN MCGAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SUDPT

Contact information

Practice address
2280 WA-821, YAKIMA, WA 98902
(509) 457-0990
(509) 454-4548
Mailing address
118 N 80TH AVE, YAKIMA, WA 98908-1517

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60932375
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
871512541
CAS
WA
Enumeration date
06/19/2020
Last updated
06/19/2020
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