Individual
MR. JAKE ALEX MEHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
2732 GRAND AVE, EVERETT, WA 98201-3416
(425) 258-2407
Mailing address
2732 GRAND AVENUE, SUITE 101, EVERETT, WA 98201-3416
(206) 940-0867
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
261QR0405X
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1124159157
EVERGREEN RECOVERY CENTER
WA
Enumeration date
12/26/2018
Last updated
08/30/2023
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