Organization
TRI-STAR BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOREN RAYMOND CAUDLE MAC/CC (DIRECTOR)
(509) 780-3081
Entity
Organization
Contact information
Practice address
302 5TH ST STE 2, CLARKSTON, WA 99403-1801
(509) 780-3081
Mailing address
302 5TH ST STE 2, CLARKSTON, WA 99403-1801
(509) 780-3081
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972943090
—
WA
Enumeration date
11/26/2019
Last updated
11/26/2019
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