Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1063726362 |
---|---|
Provider Name | Douglas Roy Mclemore |
First Address | Silverdale, WA 98383-1192 |
Second Address | Bremerton, WA 98311-9157 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2010 |
Last Update Date | 29/07/2010 |