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General NPI Number Information
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NPI Number | 1235047333
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Entity Type | Individual
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Provider Name | MARK DENNIS DEVLIN MCLEAN SUDPT: CDPT.CO.70103
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Gender | Male
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 9474 LATHROP INDUSTRIAL DR SW
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City | TUMWATER
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State | WA
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Zip | 98512-1109
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Country | US
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Telephone | 360-583-3340
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Fax | 360-322-3804
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Provider Business Mailing Address
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Address Line | 2800 LILLY RD NE
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City | OLYMPIA
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State | WA
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Zip | 98506-3005
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Country | US
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Telephone | 360-890-9831
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDPT.CO.70103865
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License Number State | WA
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