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1174214076
CLUSSIE BAGBY
RENTON, WA
NPI
1174214076
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2023-05-19
Last Update Date
2023-05-19
Business Address
Mr. CLUSSIE BAGBY
15 S GRADY WAY STE 245
RENTON, WA 98057-3209
Phone number: 206-679-8291
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Mailing Address
Mr. CLUSSIE BAGBY
15 S GRADY WAY STE 245
RENTON, WA 98057-3209
Phone number: 206-679-8291
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