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1134738222
JONATHAN THOMAS WALLIS
EVERETT, WA
NPI
1134738222
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: WA 61188175)
Additional Taxonomies
101YM0800X Counselor, Mental Health
Enumeration Date
2020-07-24
Last Update Date
2022-01-10
Business Address
JONATHAN THOMAS WALLIS MA, LMHCA
811 MADISON ST
EVERETT, WA 98203-4543
Phone number: 425-212-4200
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Mailing Address
JONATHAN THOMAS WALLIS MA, LMHCA
PO BOX 2569
EVERETT, WA 98213-0569
Phone number: 425-212-4200
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