Individual
MR. GARY R MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
627 5TH ST, SUITE 100A, MUKILTEO, WA 98275-1580
(425) 290-5757
(425) 786-9276
Mailing address
627 5TH ST, SUITE 100A, MUKILTEO, WA 98275-1580
(425) 328-9528
(425) 786-9276
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00001723
WA
Other
Enumeration date
02/14/2008
Last updated
03/12/2014
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