Doctor Name: | JASON E RAUGUST |
NPI Number: | 1013070010 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | RC |
License Number: | RC00034655 |
Business Practice Address: | 165 E Hawthorne Ave Colville, WA - 991142629 |
Business Phone Number: | 5096844597 |
Business Fax Number: | |
Mailing Address: | 56 Logan Avenue, DAVENPORT |
State: | WA |
Postal Code: | 99122 |
Phone Number: | 5097252239 |
Fax Number: | |
NPI Enumeration Date: | 12/19/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | RC00034655 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |