HEATHER ANN IVY

TACOMA, WA
NPI1225738859
Former NameHEATHER ANN SAMPLE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP61678744)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
(Licence: WA  CO61296221)
Enumeration Date2023-03-02
Last Update Date2025-07-08
Business Address
HEATHER ANN IVY SUDP III
1415 CENTER ST
TACOMA, WA 98409-8210
Phone number: 253-280-9860
Mailing Address
HEATHER ANN IVY SUDP III
9650 15TH AVE SW
SEATTLE, WA 98106-2576
Phone number: 206-965-1055