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NPI Code Detail

MEDICARE: JAMES E BARTH CP00001342

MEDICARE: JAMES E BARTH CP00001342
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) CounselorCP00001342WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CP00001342OTHERWACHEMICAL DEPENDENCY PROFESSIONAL CERTIFICATION

General Provider Information

NPI Number : 1154840122
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES E BARTH CP00001342
Provider Business Mailing Address
First Line : PO BOX 1207
Second Line :
City : YAKIMA
State : WA
Zip : 98907-1207
Country : US
Telephone Number : 509-457-5653
Fax Number : 509-457-3107
Provider Business Practice Location Address
First Line : 201 E LINCOLN AVE STE 100
Second Line :
City : YAKIMA
State : WA
Zip : 98901-2348
Country : US
Telephone Number : 509-457-5653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2017
Last Update Date : 09/11/2017

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Directions to “ JAMES E BARTH CP00001342” Practice Location

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