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Individual

JACOB PAUL SURGNIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7254
(360) 993-3000
Mailing address
6926 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98661-7254

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61606788
WA

Other

Enumeration date
12/18/2024
Last updated
12/18/2024
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