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1710952916
SAMUEL G MACK
TACOMA, WA
NPI
1710952916
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: MI 6801065054)
Enumeration Date
2006-02-21
Last Update Date
2007-07-08
Business Address
Mr. SAMUEL G MACK
9040A FITZSIMMONS AVE
TACOMA, WA 98431-0001
Phone number: 253-968-4184
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Mailing Address
Mr. SAMUEL G MACK
1311 ROWAN CT
DUPONT, WA 98327-8776
Phone number: 253-968-4184
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