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1942913603
JEFFREY DALE FORD
SPOKANE, WA
NPI
1942913603
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CO61319735)
Enumeration Date
2022-12-27
Last Update Date
2022-12-27
Business Address
JEFFREY DALE FORD SUDPt
4301 W SUNSET BLVD
SPOKANE, WA 99224-5157
Phone number: 509-953-6674
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Mailing Address
JEFFREY DALE FORD SUDPt
975 E NORTH FOOTHILLS DR APT B102
SPOKANE, WA 99207-2716
Phone number: 509-953-5768
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