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General NPI Number Information
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NPI Number | 1184499493
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Entity Type | Individual
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Provider Name | JOHN DAVID COLE
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Gender | Male
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Dates
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Enumeration Date | 11/16/2023
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 19557 1ST AVE NW
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City | SHORELINE
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State | WA
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Zip | 98177-2502
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Country | US
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Telephone | 206-963-2905
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Fax |
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Provider Business Mailing Address
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Address Line | 19557 1ST AVE NW
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City | SHORELINE
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State | WA
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Zip | 98177-2502
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CL60138775
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License Number State | WA
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