Individual
TONYA DOROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2232 S SILVER LAKE RD, CASTLE ROCK, WA 98611-8021
(360) 274-3262
Mailing address
1057 12TH AVE, LONGVIEW, WA 98632-2509
(360) 274-3262
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60235863
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2084529
—
WA
Enumeration date
02/08/2016
Last updated
09/04/2023
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