JEREMY JOHANSEN

TACOMA, WA
NPI1710455829
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO60872001)
Enumeration Date2018-11-06
Last Update Date2018-11-06
Business Address
JEREMY JOHANSEN CDP-T
758 ST HELENS AVE
TACOMA, WA 98402-3706
Phone number: 253-274-0484
Mailing Address
JEREMY JOHANSEN CDP-T
758 ST HELENS AVE
TACOMA, WA 98402-3706
Phone number: 253-274-0484