MARK CARL SIVESIND

PORT ANGELES, WA
NPI1457966418
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  61083927)
Enumeration Date2020-09-15
Last Update Date2020-09-15
Business Address
MARK CARL SIVESIND SUDPT
806 S VINE ST
PORT ANGELES, WA 98362-7982
Phone number: 360-452-2443
Mailing Address
MARK CARL SIVESIND SUDPT
806 S VINE ST
PORT ANGELES, WA 98362-7982
Phone number: 360-452-2443