Provider Demographics
NPI:1841624822
Name:YORK, JAMES WILLIAM
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:YORK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:YORK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5019 GROVE ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-4491
Mailing Address - Country:US
Mailing Address - Phone:360-654-4615
Mailing Address - Fax:
Practice Address - Street 1:5019 GROVE ST STE 102
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-4491
Practice Address - Country:US
Practice Address - Phone:360-654-4615
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-27
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist