Individual
MR. MARK BAKER WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
1305 WYOMING ST, MISSOULA, MT 59801-1725
(406) 532-9770
Mailing address
T-9 FORT MISSOULA, MISSOULA, MT 59804-7202
(406) 532-8400
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
806
MT
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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