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1164994109
SAMANTHA KELLY ANDERSON
VANCOUVER, WA
NPI
1164994109
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CO60912422)
Enumeration Date
2018-12-31
Last Update Date
2018-12-31
Business Address
Ms. SAMANTHA KELLY ANDERSON CDPT
1601 E FOURTH PLAIN BLVD
VANCOUVER, WA 98661-3713
Phone number: 360-397-8246
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Mailing Address
Ms. SAMANTHA KELLY ANDERSON CDPT
971 4TH ST
WASHOUGAL, WA 98671-1001
Phone number: 136-083-1531
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