Individual
JANIEL EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CG
Contact information
Practice address
840 E PLUM ST, MOSES LAKE, WA 98837-1874
(509) 765-9239
(509) 765-4124
Mailing address
840 E PLUM ST, MOSES LAKE, WA 98837-1874
(509) 765-9239
(509) 765-4124
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60407185
WA
Other
Enumeration date
10/17/2013
Last updated
10/17/2013
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