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NPI Code Detail

MEDICARE: JESUS JAVIER DELGADO

MEDICARE: JESUS JAVIER DELGADO
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 CounselorRC00048128WA

General Provider Information

NPI Number : 1639341688
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESUS JAVIER DELGADO
Provider Business Mailing Address
First Line : PO BOX 1323
Second Line :
City : PASCO
State : WA
Zip : 99301-1323
Country : US
Telephone Number : 509-547-2204
Fax Number : 509-542-8836
Provider Business Practice Location Address
First Line : 720 W COURT ST
Second Line : SUITE 8
City : PASCO
State : WA
Zip : 99301-4178
Country : US
Telephone Number : 509-545-6506
Fax Number : 509-546-0520
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2008
Last Update Date : 03/31/2008

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Directions to “ JESUS JAVIER DELGADO ” Practice Location

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