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Contact Information

OZARK GORE
4804 LACEY BLVD SE STE A
LACEY, WA98503-5733
 Phone: 360-799-5782
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for OZARK GORE · (Male)

NPI Number 1750916086
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2020
Last updated 03/06/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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