Provider Demographics
NPI:1073696290
Name:HUGHES, JOHN D (PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:HUGHES
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 STANTON ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2058
Mailing Address - Country:US
Mailing Address - Phone:509-876-1477
Mailing Address - Fax:
Practice Address - Street 1:73 S PALOUSE ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-1925
Practice Address - Country:US
Practice Address - Phone:509-876-1477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 00003427103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling