Individual
JESSICA MARIE BAMBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
716 S CHASE ST, PORT ANGELES, WA 98362-6122
(360) 395-2976
Mailing address
2323 E 4TH AVE, PORT ANGELES, WA 98362-9012
(360) 821-8782
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60908895
WA
Other
Enumeration date
11/23/2021
Last updated
11/23/2021
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