Provider Demographics
NPI:1124290135
Name:STEWARD, JUSTIN E
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:E
Last Name:STEWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10911 OLD NACHES HWY
Mailing Address - Street 2:
Mailing Address - City:NACHES
Mailing Address - State:WA
Mailing Address - Zip Code:98937-8767
Mailing Address - Country:US
Mailing Address - Phone:509-654-3693
Mailing Address - Fax:
Practice Address - Street 1:10911 OLD NACHES HWY
Practice Address - Street 2:
Practice Address - City:NACHES
Practice Address - State:WA
Practice Address - Zip Code:98937-8767
Practice Address - Country:US
Practice Address - Phone:509-654-3693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor