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Individual

JAMES E KONOPASEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
502 WASHINGTON ST, SUITE 206B, THE DALLES, OR 97058-2270
(541) 490-7673
(541) 298-5653
Mailing address
502 WASHINGTON ST, SUITE 206B, THE DALLES, OR 97058-2270
(541) 490-7673
(541) 298-5653

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
FC00000109
WA
171W00000X
Contractor
Primary
POLYG EXAMINER - 173
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
215538
WA DSHS PROVIDER NUMBER
WA
01
298043
OMAP PROVIDER NUMBER
OR
01
L43392
DHS PROVIDER NUMBER
OR
Enumeration date
06/29/2007
Last updated
09/11/2025
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