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General NPI Number Information
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NPI Number | 1770445512
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Entity Type | Individual
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Provider Name | ROGER JAY STANTON JR.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 1819 E 72ND ST
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City | TACOMA
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State | WA
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Zip | 98404-5499
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Country | US
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Telephone | 253-777-0766
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 37
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City | PUYALLUP
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State | WA
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Zip | 98371-0135
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Country | US
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Telephone | 253-777-0766
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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 | MC70033152
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License Number State | WA
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