Individual
MR. JAMES MARK CREA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
2502 TACOMA AVE S, TACOMA, WA 98402
(253) 759-0852
Mailing address
114 N 3RD STREET, MONTESANO, WA 98563
(360) 593-7030
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CP 00006301
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP 00006301
CHEMICAL DEPENDENCY PROFESSIONAL CERTIFACATION NUMBER
WA
Enumeration date
12/14/2010
Last updated
12/14/2010
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