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Individual

WALTER WILLIAM COBURN I

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1960 THOMPSON DR, SEDRO WOOLLEY, WA 98284-5007
(360) 856-3186
Mailing address
1203 E SECTION ST, MOUNT VERNON, WA 98274-5020
(253) 227-1844

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LP60342552
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
164W00000X
Licensed Practical Nurse
Primary
LP60342552
WA

Other

Enumeration date
02/06/2023
Last updated
02/06/2023
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