Provider Demographics
NPI:1629514476
Name:GUFFEY, JAMES DALE JR
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DALE
Last Name:GUFFEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4212 210TH PL NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-9357
Mailing Address - Country:US
Mailing Address - Phone:314-479-3279
Mailing Address - Fax:
Practice Address - Street 1:4212 210TH PL NE
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-9357
Practice Address - Country:US
Practice Address - Phone:314-479-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-17
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician