| Mr Jack Otto Lehmann, | |
|
230 E State St, Mossyrock, WA 98564 | |
| (360) 983-3227 | |
| (360) 983-3289 |
| Full Name | Mr Jack Otto Lehmann |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 230 E State St, Mossyrock, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679090294 | NPI | - | NPPES |
| 1991983 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CO60628423 (Washington) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jack Otto Lehmann, Po Box 87, Mossyrock, WA 98564-0087 Ph: (360) 983-3227 | Mr Jack Otto Lehmann, 230 E State St, Mossyrock, WA 98564 Ph: (360) 983-3227 |
David Richard Baldwin, CP00006153 Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 East State Street, Mossyrock, WA 98564 Phone: 360-983-3257 | |
Amanda Louise Black, SUDPT Counselor Medicare: Not Enrolled in Medicare Practice Location: 230 E State St, Mossyrock, WA 98564 Phone: 360-266-5585 Fax: 360-262-6620 |