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Individual

VINCENT JOHN STRAUBE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
748 14TH AVENUE, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632
(360) 200-5419
(360) 200-6736

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
60716189
WA
175T00000X
Peer Specialist
Primary
CG60716189
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2136686
WA
Enumeration date
08/05/2011
Last updated
10/29/2020
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