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NPI Code Detail

MEDICARE: DAMIAN JAMIE FAVILA

MEDICARE: DAMIAN JAMIE FAVILA
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
1101YM0800XMental Health CounselorWA

General Provider Information

NPI Number : 1598622342
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAMIAN JAMIE FAVILA
Provider Business Mailing Address
First Line : 2555 BELLA COOLA LN APT C217
Second Line :
City : RICHLAND
State : WA
Zip : 99352-5118
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1175 CARONDELET DR
Second Line :
City : RICHLAND
State : WA
Zip : 99354-3300
Country : US
Telephone Number : 509-943-9104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2026
Last Update Date : 01/05/2026

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