Individual
JEREMIAH J DUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 798-7935
Mailing address
1601 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3713
(360) 798-7935
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L7526
OR
Other
Enumeration date
03/20/2019
Last updated
03/20/2019
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