Provider Demographics
NPI:1891950630
Name:WEBB, ALLEN DOUGLAS JR (BA)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:DOUGLAS
Last Name:WEBB
Suffix:JR
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1201 SOUTH PROCTOR
Mailing Address - Street 2:COMPREHENSIVE MENTAL HEALTH
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-396-3800
Mailing Address - Fax:253-566-2252
Practice Address - Street 1:815 S PEARL
Practice Address - Street 2:PEARL STREET CENTER
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465
Practice Address - Country:US
Practice Address - Phone:253-396-5930
Practice Address - Fax:253-566-2252
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA323P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility