JASON IMMANUEL BRANDIS

CHEHALIS, WA
NPI1477161552
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  61077105)
Enumeration Date2020-07-15
Last Update Date2022-02-24
Business Address
JASON IMMANUEL BRANDIS SUDPT
1956 NE KRESKY AVE
CHEHALIS, WA 98532-2307
Phone number: 360-740-4380
Mailing Address
JASON IMMANUEL BRANDIS SUDPT
PO BOX 59
CHEHALIS, WA 98532-0059
Phone number: 360-740-4380
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