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1598153280
JEROME WALTERS
TUKWILA, WA
NPI
1598153280
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 00006135)
Enumeration Date
2015-01-03
Last Update Date
2015-01-03
Business Address
-- JEROME WALTERS CDP
3715 S 141ST ST APT 6
TUKWILA, WA 98168-4049
Phone number: 206-747-6446
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Mailing Address
-- JEROME WALTERS CDP
PO BOX 48322
SEATTLE, WA 98148-0322
Phone number: 206-747-6446
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