Provider Demographics
NPI:1992084982
Name:COLUMBIA COUNSELING
Entity type:Organization
Organization Name:COLUMBIA COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEMICAL DEPENDENCY COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CDPT
Authorized Official - Phone:509-888-4404
Mailing Address - Street 1:610 N MISSION ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-2065
Mailing Address - Country:US
Mailing Address - Phone:509-888-4404
Mailing Address - Fax:509-888-2741
Practice Address - Street 1:610 N MISSION ST
Practice Address - Street 2:SUITE 200
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2065
Practice Address - Country:US
Practice Address - Phone:509-888-4404
Practice Address - Fax:509-888-2741
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60164382251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA967466306OtherDUNS