DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MILES RAPHAEL WEISS GINGRICH

MEDICARE: MILES RAPHAEL WEISS GINGRICH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) CounselorCDPT.CO.70142848WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CDPT.CO.70142848OTHERWASUDPT LICENSE FROM DOH

General Provider Information

NPI Number : 1093649279
Entity Type Code : Individual
Provider Name (Legal Business Name) : MILES RAPHAEL WEISS GINGRICH
Provider Business Mailing Address
First Line : 10 LOGANBERRY LN
Second Line :
City : BELLINGHAM
State : WA
Zip : 98229-4417
Country : US
Telephone Number : 505-365-9160
Fax Number :
Provider Business Practice Location Address
First Line : 1905 CONTINENTAL PL
Second Line :
City : MOUNT VERNON
State : WA
Zip : 98273-5633
Country : US
Telephone Number : 360-755-6400
Fax Number : 360-755-6407
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2026
Last Update Date : 06/11/2026

Similar Medicare Providers

1609920123 — SKAGIT RECOVERY CENTER
Practice Location Address:
1905 CONTINENTAL PL
MOUNT VERNON, WA
98273-5633
Practice Phone: 360-428-7835
Practice Fax: 360-848-9225
1568839942 — NICOLE MARIE ERVIN MHCA.MC.70119748
Practice Location Address:
1905 CONTINENTAL PL
MOUNT VERNON, WA
98273-5633
Practice Phone: 360-441-3497
Practice Fax:
1538769310 — ALLEN ROY EASLEY
Practice Location Address:
1905 CONTINENTAL PL
MOUNT VERNON, WA
98273-5633
Practice Phone: 360-755-6406
Practice Fax:
1255920757 — ERICA MANNING SUDPT
Practice Location Address:
1905 CONTINENTAL PL
MOUNT VERNON, WA
98273-5633
Practice Phone: 360-755-6400
Practice Fax:
1720666779 — PHILIPP C TURNER CPC
Practice Location Address:
1905 CONTINENTAL PL
MOUNT VERNON, WA
98273-5633
Practice Phone: 360-755-6405
Practice Fax: 360-755-6407
1619557618 — TAYLOR JAMES HASLETT
Practice Location Address:
1905 CONTINENTAL PL
MOUNT VERNON, WA
98273-5633
Practice Phone: 360-755-6405
Practice Fax: 360-755-6407

Directions to “ MILES RAPHAEL WEISS GINGRICH ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.