Individual
JILL LYNNETTE PATRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AAS, CDP
Contact information
Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 740-2539
Mailing address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 740-2539
(360) 740-2551
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00004308
WA
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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