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1578064895
BRUCE WAYNE DAVIS
TACOMA, WA
NPI
1578064895
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 60715316)
Enumeration Date
2018-02-22
Last Update Date
2018-02-22
Business Address
BRUCE WAYNE DAVIS
510 TACOMA AVE S
TACOMA, WA 98402-5416
Phone number: 253-502-5416
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Mailing Address
BRUCE WAYNE DAVIS
510 TACOMA AVE S
TACOMA, WA 98402-5416
Phone number: 253-502-5416
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