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1477161552
JASON IMMANUEL BRANDIS
CHEHALIS, WA
NPI
1477161552
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA 61077105)
Enumeration Date
2020-07-15
Last Update Date
2022-02-24
Business Address
JASON IMMANUEL BRANDIS SUDPT
1956 NE KRESKY AVE
CHEHALIS, WA 98532-2307
Phone number: 360-740-4380
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Mailing Address
JASON IMMANUEL BRANDIS SUDPT
PO BOX 59
CHEHALIS, WA 98532-0059
Phone number: 360-740-4380
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