MR. GARY R MCCULLOUGH CDP NPI 1720256555

NPI Information

NPI: 1720256555
Provider Name: MR. GARY R MCCULLOUGH, CDP
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
627 5TH ST
SUITE 100A
MUKILTEO, WA
ZIP 98275
Phone: (425) 290-5757
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MR. Gary R Mccullough, CDP is an addiction (substance use disorder) counselor in Mukilteo, WA. MR. Gary R Mccullough, CDP NPI is 1720256555. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

627 5TH ST
SUITE 100A
MUKILTEO, WA
ZIP 98275-580
Phone: (425) 290-5757
Fax: (425) 786-9276

The enumeration date for this NPI number is 2/14/2008 and was last updated on 3/12/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	CP00001723	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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