is a Addiction (substance Use Disorder) in Kingston, Washington. practices all healthcare services and medical treatments related to Addiction (substance Use Disorder). The NPI Number for is 1487765368. The last update date is .
's current location address is 32014 Little Boston Rd Ne, Kingston, Washington. You can contact this provider via phone number 3602979601 and fax number 3602979614. The mailing address for is 32014 Little Boston Rd Ne, Kingston, Washington. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 32014 Little Boston Rd Ne, Kingston, Washington |
Phone Number | 3602979601 |
Fax Number | 3602979614 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1487765368 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 32014 Little Boston Rd Ne |
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City | Kingston |
State | Washington (WA) |
Post Code | 983469734 |
Phone Number | 3602979601 |
Fax Number | 3602979614 |
Provider's Primary Taxonomy Detail
Speciality | Addiction (substance Use Disorder) |
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Taxonomy | 101Ya0400X |
Licence No | RC00051687 |
Definition: A counselor who helps people with alcohol, drug, gambling, internet, and other types of addictions. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
190875163-19 | WA | KPS ID# | |
PO1521 | WA | REGENCE RIDER# | |
1992825 | WA | -- |
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