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Individual

JAN DAVID ANDRUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6701 N IDAHO RD, NEWMAN LAKE, WA 99025-9557
(208) 329-7676
Mailing address
1121 E MULLAN AVE APT 2, COEUR D ALENE, ID 83814-4054
(208) 329-7676

Taxonomy

Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary

Other

Enumeration date
08/22/2022
Last updated
08/24/2022
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