Healthcare Provider Details

I. General information

NPI: 1427977180
Provider Name (Legal Business Name): JASON ALAN DONG LMHCA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 SE GRACE AVE
BATTLE GROUND WA
98604-3526
US

IV. Provider business mailing address

4021 NE BEASLEY RD
LA CENTER WA
98629-2238
US

V. Phone/Fax

Practice location:
  • Phone: 360-203-6969
  • Fax:
Mailing address:
  • Phone: 360-213-9059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.61649420
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: