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1134854417
TAYA M WALLENBERG
MOUNT VERNON, WA
NPI
1134854417
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-07-20
Last Update Date
2022-07-20
Business Address
TAYA M WALLENBERG
1601 E COLLEGE WAY
MOUNT VERNON, WA 98273-5612
Phone number: 206-461-4880
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Mailing Address
TAYA M WALLENBERG
4905 61ST DR NE
MARYSVILLE, WA 98270-7552
Phone number: 425-903-1361
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