Healthcare Provider Details

I. General information

NPI: 1982082350
Provider Name (Legal Business Name): JOHN DANIEL SPRAGGINS CRC, CDMS, VRC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2015
Last Update Date: 05/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 140TH AVE NE STE 110
BELLEVUE WA
98005-1862
US

IV. Provider business mailing address

9617 7TH AVE SE
EVERETT WA
98208-3710
US

V. Phone/Fax

Practice location:
  • Phone: 425-644-4100
  • Fax: 425-644-4101
Mailing address:
  • Phone: 425-513-8509
  • Fax: 425-290-9774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number9976
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: