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Individual

JOSHUA CALDERON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SUDP

Contact information

Practice address
1905 CONTINENTAL PL, MOUNT VERNON, WA 98273-5633
(360) 755-6400
(360) 755-6407
Mailing address
1905 CONTINENTAL PL, MOUNT VERNON, WA 98273-5633
(360) 755-6400
(360) 755-6407

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
WDL61SP4C33B
DRIVERS LICENSE
WA
Enumeration date
02/20/2023
Last updated
02/20/2023
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