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1588080063
KELLEY NELSON WHITTY-SANDAKER
TACOMA, WA
NPI
1588080063
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA CO60367121)
Enumeration Date
2014-03-08
Last Update Date
2018-01-04
Business Address
KELLEY NELSON WHITTY-SANDAKER CDP
504 112TH ST S
TACOMA, WA 98444-5720
Phone number: 253-536-5549
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Mailing Address
KELLEY NELSON WHITTY-SANDAKER CDP
1119 TACOMA AVE S
TACOMA, WA 98402-2005
Phone number: 253-246-6820
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