Doctor Name: | DAVID LEWIS MCLEOD |
NPI Number: | 1003110800 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | CDP |
License Number: | CP00003404 |
Business Practice Address: | 2502 Tacoma Ave S Tacoma, WA - 984021310 |
Business Phone Number: | 2537590852 |
Business Fax Number: | |
Mailing Address: | Po Box 5305, TACOMA |
State: | WA |
Postal Code: | 984150305 |
Phone Number: | 2537590852 |
Fax Number: | |
NPI Enumeration Date: | 01/07/2011 |
NPI Last Update Date: | 01/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CP00003404 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |