THERON REGINALD PARKS

TACOMA, WA
NPI1467923003
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CP60838935)
Enumeration Date2018-12-07
Last Update Date2018-12-07
Business Address
Mr. THERON REGINALD PARKS CDP
721 FAWCETT AVE
TACOMA, WA 98402-5502
Phone number: 253-284-7820
Mailing Address
Mr. THERON REGINALD PARKS CDP
945 FAWCETT AVE
TACOMA, WA 98402-5612
Phone number: