DERIK L SANDOVAL

ABERDEEN, WA
NPI1174137152
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO60987238)
Enumeration Date2020-09-07
Last Update Date2021-05-05
Business Address
Mr. DERIK L SANDOVAL SUDPT
2700 SIMPSON AVE SUITE 101
ABERDEEN, WA 98520
Phone number: 360-612-0012
Mailing Address
Mr. DERIK L SANDOVAL SUDPT
PO BOX 1847
LONGVIEW, WA 98632
Phone number: 360-234-0203
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