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Organization

COLONIAL CLINIC II, LLC

Active
Other names
Colonial Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DANIEL J. COLYAR MA,CDP,NCACII,SAP (EXECUTIVE DIRECTOR)
(509) 327-9831
Entity
Organization

Contact information

Practice address
910 N WASHINGTON ST, SUITE 210, SPOKANE, WA 99201-2202
(509) 327-9831
(509) 327-9857
Mailing address
910 N WASHINGTON ST, SUITE 210, SPOKANE, WA 99201-2202
(509) 327-9831
(509) 327-9857

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
32025500
CHEMICAL DEPENDENCY TREAT
WA
01
J0HY6W00
ONE HLTH. PORT ID.
WA
Enumeration date
10/28/2005
Last updated
03/15/2012
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