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Individual

JASON GUEST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
145 S WORTHEN ST, WENATCHEE, WA 98801
(509) 662-6761
Mailing address
145 S WORTHEN ST, WENATCHEE, WA 98801-3081
(509) 662-6761

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60864912
WA
104100000X
Social Worker
Primary
LW60631148
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2069864
WA
Enumeration date
10/28/2015
Last updated
10/11/2018
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