Provider Demographics
NPI:1053814368
Name:SLUSHER, JAMES BRIAN SR (CDPT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:SLUSHER
Suffix:SR
Gender:M
Credentials:CDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19201 120TH AVE NE STE 108
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-9523
Mailing Address - Country:US
Mailing Address - Phone:425-485-6541
Mailing Address - Fax:425-485-4154
Practice Address - Street 1:19201 120TH AVE NE STE 108
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-9523
Practice Address - Country:US
Practice Address - Phone:425-485-6541
Practice Address - Fax:425-485-4154
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60425031101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO60425031OtherWASHINGTON STATE DEPARTMENT OF HEALTH