Individual
JOHN LANELL FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAC, CPC
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
WA
171M00000X
Case Manager/Care Coordinator
—
WA
175T00000X
Peer Specialist
Primary
CG61163067
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2176426
—
WA
Enumeration date
02/25/2021
Last updated
01/06/2022
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