Provider Demographics
NPI:1154461325
Name:YOUNG, JAMES ALLEN (BSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ALLEN
Last Name:YOUNG
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 UNIVERSITY LN APT 218
Mailing Address - Street 2:
Mailing Address - City:CHENEY
Mailing Address - State:WA
Mailing Address - Zip Code:99004-2056
Mailing Address - Country:US
Mailing Address - Phone:509-559-5569
Mailing Address - Fax:
Practice Address - Street 1:7 S HOWARD ST STE 321
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-3816
Practice Address - Country:US
Practice Address - Phone:509-838-4128
Practice Address - Fax:509-838-4816
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00055371390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program