Individual
TIMOTHY FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO60886724
Contact information
Practice address
120 S 3RD ST, YAKIMA, WA 98901-2875
(509) 865-6705
Mailing address
1212 S 8TH AVE, YAKIMA, WA 98902-5511
(509) 865-6705
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60886724
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91-0755984
—
WA
Enumeration date
12/16/2018
Last updated
12/16/2018
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