Individual
PAULA M GORMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(509) 685-0656
Mailing address
398 CORBETT CREEK RD, COLVILLE, WA 99114-9668
(509) 685-1354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00004731
WA
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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