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Jacob Phillips, CPC
Peer Specialist in Ridgefield, Washington
NPI 1770211047

Jacob Phillips is a Peer Specialist based in Battle Ground, WA. Jacob Phillips practices in Ridgefield, WA and has the professional credentials of CPC. The NPI Number for Jacob Phillips is 1770211047 and holds a License No. CG61240416 (Washington).

The current practice location address for Jacob Phillips is 21810 Ne 37Th Ave, Ridgefield, WA and can be reached out via phone at 360-241-5695.

Location: 21810 Ne 37Th Ave, Ridgefield, WA, 98604-1299
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770211047
Provider Name
Jacob Phillips
Credential
CPC
Provider Entity Type
Individual
Gender
Male
Address
21810 Ne 37Th Ave, Ridgefield, WA, 98604-1299
Phone Number
360-241-5695
Fax Number
Provider Enumeration Date
08/12/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
21810 Ne 37Th Ave
City
Ridgefield
State
Washington
Zip
98642-7747
Phone Number
360-241-5695
Fax Number
person
Provider Business Mailing Address Details
Address
21810 Ne 37Th Ave
City
Ridgefield
State
Washington
Zip
98642-7747
Phone Number
360-241-5695
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
CG61240416 (Washington)
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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