Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | LH60711972 | WA |
NPI | 1003118589 |
---|---|
Provider Name | Mr. Jedadiah Eslinger |
First Address | Walla Walla, WA 99362-1507 |
Second Address | Walla Walla, WA 99362-5009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2010 |
Last Update Date | 05/10/2018 |