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1003090903
JAMES C WASHINGTON
WAGONER, OK
NPI
1003090903
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-12-27
Last Update Date
2007-12-27
Business Address
-- JAMES C WASHINGTON
301 SE 11TH ST
WAGONER, OK 74467-7513
Phone number: 918-485-5404
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Mailing Address
-- JAMES C WASHINGTON
PO BOX 558
TAHLEQUAH, OK 74465-0558
Phone number: 918-485-8404
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