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1710455829
JEREMY JOHANSEN
TACOMA, WA
NPI
1710455829
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: WA CO60872001)
Enumeration Date
2018-11-06
Last Update Date
2018-11-06
Business Address
JEREMY JOHANSEN CDP-T
758 ST HELENS AVE
TACOMA, WA 98402-3706
Phone number: 253-274-0484
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Mailing Address
JEREMY JOHANSEN CDP-T
758 ST HELENS AVE
TACOMA, WA 98402-3706
Phone number: 253-274-0484
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