Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | CG60586698 | WA |
NPI | 1003328261 |
---|---|
Provider Name | Mohammed Yunus |
First Address | Longview, WA 98632-2316 |
Second Address | Longview, WA 98632-2316 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2017 |
Last Update Date | 27/10/2017 |