Provider Demographics
NPI:1457410391
Name:PRICE, DUANE THOMAS (CASE MANAGER)
Entity Type:Individual
Prefix:MR
First Name:DUANE
Middle Name:THOMAS
Last Name:PRICE
Suffix:
Gender:M
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 ESKRIDGE WAY SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-3452
Mailing Address - Country:US
Mailing Address - Phone:360-350-8769
Mailing Address - Fax:
Practice Address - Street 1:4313 6TH AVE SE STE C
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1072
Practice Address - Country:US
Practice Address - Phone:360-350-8769
Practice Address - Fax:360-878-9335
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
WA00001669106H00000X, 101YM0800X
WALF00001669106H00000X
WACO6066813101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)