person
Mr. Jason Raydr-scott Gomez, SUDP
Addiction (Substance Use Disorder) Counselor in Kingston, Washington
NPI 1336603026

Jason Raydr-scott Gomez is an Addiction (Substance Use Disorder) Counselor based in Kingston, WA and is specialized in Addiction (Substance Use Disorder). Jason Raydr-scott Gomez practices in Kingston, WA and has the professional credentials of SUDP. The NPI Number for Jason Raydr-scott Gomez is 1336603026 and holds a License No. 60777486 (Washington).

The current practice location address for Jason Raydr-scott Gomez is 31912 Little Boston Rd Ne, Kingston, WA and can be reached out via phone at 360-297-6329.

Location: 31912 Little Boston Rd Ne, Kingston, WA, 98346-9734
person
Provider Profile Details
NPI Number
1336603026
Provider Name
Jason Raydr-scott Gomez
Credential
SUDP
Provider Entity Type
Individual
Gender
Male
Address
31912 Little Boston Rd Ne, Kingston, WA, 98346-9734
Phone Number
360-297-6329
Fax Number
Provider Enumeration Date
01/26/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
61031153 01 WA SUDP CREDINTENTIAL
institution
Provider Business Practice Location Address Details
Address
31912 Little Boston Rd Ne
City
State
Zip
98346-9700
Phone Number
360-297-6329
Fax Number
person
Provider Business Mailing Address Details
Address
31912 Little Boston Rd Ne
City
State
Zip
98346-9700
Phone Number
360-297-6329
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
60777486 (Washington)
Definition
Definition to come...
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