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1275001620
MATTHEW MIXON
TACOMA, WA
NPI
1275001620
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2018-11-04
Last Update Date
2018-11-04
Business Address
MATTHEW MIXON
15318 14TH AVENUE CT E
TACOMA, WA 98445-2496
Phone number: 253-324-3616
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Mailing Address
MATTHEW MIXON
15318 14TH AVENUE CT E
TACOMA, WA 98445-2496
Phone number: 253-324-3583
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