Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | CP00004470 | WA |
Y | 1041C0700X | Clinical Social Worker | LW00009754 | WA |
NPI | 1003928052 |
---|---|
Provider Name | Mr. David N Silva |
First Address | Walla Walla, WA 99362-3975 |
Second Address | Walla Walla, WA 99362-3975 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 04/02/2019 |