Provider Demographics
NPI:1689855579
Name:CAUTHERS, WES (MACP, RMHC)
Entity type:Individual
Prefix:MR
First Name:WES
Middle Name:
Last Name:CAUTHERS
Suffix:
Gender:M
Credentials:MACP, RMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 BRIDGEPORT WAY W # E3
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4328
Mailing Address - Country:US
Mailing Address - Phone:425-268-0060
Mailing Address - Fax:253-465-5922
Practice Address - Street 1:4109 BRIDGEPORT WAY W # E3
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4328
Practice Address - Country:US
Practice Address - Phone:425-268-0060
Practice Address - Fax:253-465-5922
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60155395101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health