| Mr Robert J Lagerquist, CHEMICAL DEPENDENCY | |
|
1505 Kla-ook-wa Street, Taholah, WA 98587-0219 | |
| (360) 276-4405 | |
| (360) 276-4474 |
| Full Name | Mr Robert J Lagerquist |
|---|---|
| Gender | Male |
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1505 Kla-ook-wa Street, Taholah, Washington |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699911875 | NPI | - | NPPES |
| 1992817 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | CP00004415 (Washington) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Robert J Lagerquist, CHEMICAL DEPENDENCY Po Box 219, Taholah, WA 98587-0219 Ph: (360) 276-4405 | Mr Robert J Lagerquist, CHEMICAL DEPENDENCY 1505 Kla-ook-wa Street, Taholah, WA 98587-0219 Ph: (360) 276-4405 |
Mishelle Jackson, SUDPT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1505 Kla-ook-wa Dr, Taholah, WA 98587 Phone: 360-276-8215 | |
Leland Wayne Baker, MSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1505 Kla-ook-wah Dr, Taholah, WA 98587 Phone: 360-276-4405 Fax: 360-276-4474 | |
Alex Eugene Fabini, MA, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1505 Kla-ook-wa Drive, Taholah, WA 98587 Phone: 360-276-8215 Fax: 360-276-4104 | |
Mrs. Hope Errin Edwards, MS, NCC, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1505 Kla-ook-wa Way, Taholah, WA 98587 Phone: 360-276-8215 Fax: 360-276-4104 | |
Susan C Davis, MENTAL HEALTH Counselor Medicare: Not Enrolled in Medicare Practice Location: 1505 Kla-ook-wa Drive, Taholah, WA 98587 Phone: 360-276-4405 Fax: 360-276-4474 | |
Tamara A Dudley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1505 Kla-ook-wa Drive, Taholah, WA 98587 Phone: 360-276-4405 Fax: 360-276-4104 |