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Individual

MR. JONATHAN HAL DEBOARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
MADIGAN ARMY MEDICAL CTR, 9040 REID ST., ATTN: MCHJ-QCR, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278
Mailing address
MADIGAN ARMY MEDICAL CTR, 9040 REID ST., ATTN: MCHJ-QCR, TACOMA, WA 98431-1100
(253) 968-2252
(253) 968-3278

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.004897
IL

Other

Enumeration date
10/23/2009
Last updated
10/23/2009
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