Haynes, Judson Austin
Haynes, Judson Austin is an individual health care provider with primary practice located at 260 Kala Point Dr Ste 102 , Port Townsend WA 98368-9530. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Haynes, Judson Austin can be contacted via phone (360) 698-5883.Contact Information
Primary practice address
260 Kala Point Dr Ste 102
Port Townsend WA 98368-9530
Phone: (360) 698-5883
Fax: (360) 809-6002
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CP60211997 | Washington |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LH60531241 | Washington |
Profile Details
| NPI number | 1346650298 |
|---|---|
| LBN Legal business name | Haynes, Judson Austin |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 30th, 2014 |
| Last updated | Nov 20th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346650298 | NPPES |
| Washington | MEDICAID | 2254794 |
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