Provider Demographics
NPI:1235881657
Name:GARCIA, JORGE ARTURO (SUDPT)
Entity Type:Individual
Prefix:
First Name:JORGE
Middle Name:ARTURO
Last Name:GARCIA
Suffix:
Gender:M
Credentials:SUDPT
Other - Prefix:
Other - First Name:JORGE
Other - Middle Name:ARTURO
Other - Last Name:GARCIA AMADOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:SUDPT
Mailing Address - Street 1:619 RICE CT
Mailing Address - Street 2:
Mailing Address - City:STEILACOOM
Mailing Address - State:WA
Mailing Address - Zip Code:98388-3609
Mailing Address - Country:US
Mailing Address - Phone:206-355-7822
Mailing Address - Fax:
Practice Address - Street 1:5915 ORCHARD ST W
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98467-3824
Practice Address - Country:US
Practice Address - Phone:253-414-7461
Practice Address - Fax:253-627-8387
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty