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1699228049
JEROME DOHERTY
SEATTLE, WA
NPI
1699228049
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 1006)
Enumeration Date
2016-08-02
Last Update Date
2016-08-02
Business Address
-- JEROME DOHERTY CDP
11000 LAKE CITY WAY NE
SEATTLE, WA 98125-6748
Phone number: 206-632-5009
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Mailing Address
-- JEROME DOHERTY CDP
11000 LAKE CITY WAY NE
SEATTLE, WA 98125-6748
Phone number: 206-632-5009
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