Individual
JEREMY RAE DEERHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
401 S MAIN ST, DEER PARK, WA 99006
(509) 444-8200
Mailing address
611 N IRON BRIDGE WAY, SPOKANE, WA 99202-4932
(509) 444-8888
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60420761
WA
104100000X
Social Worker
Primary
LW60899726
WA
Other
Enumeration date
10/30/2018
Last updated
03/16/2021
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