Healthcare Provider Details

I. General information

NPI: 1285825497
Provider Name (Legal Business Name): DARRELL RAY CHAMBERS CDPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2007
Last Update Date: 08/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 E 1ST ST STE 2
PORT ANGELES WA
98362-4020
US

IV. Provider business mailing address

1026 E 1ST ST STE 2
PORT ANGELES WA
98362-4020
US

V. Phone/Fax

Practice location:
  • Phone: 360-452-4432
  • Fax:
Mailing address:
  • Phone: 360-452-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: