Individual
JAKE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3400 W GARLAND AVE, SPOKANE, WA 99205-2119
(509) 325-2355
Mailing address
3400 W GARLAND AVE, SPOKANE, WA 99205-2119
(509) 325-2355
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60964743
WA
Other
Enumeration date
12/19/2019
Last updated
12/19/2019
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