Healthcare Provider Details

I. General information

NPI: 1881231207
Provider Name (Legal Business Name): GEORGE EDWARD HUMES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2019
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5506 JOHNSON DR
PASCO WA
99301-8479
US

IV. Provider business mailing address

5506 JOHNSON DR
PASCO WA
99301-8479
US

V. Phone/Fax

Practice location:
  • Phone: 970-324-9278
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61673657
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: