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1750812152
MARK GRANNEMANN
TUMWATER, WA
NPI
1750812152
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WA CG60154298)
Enumeration Date
2017-03-27
Last Update Date
2020-01-13
Business Address
MARK GRANNEMANN
6128 CAPITOL BLVD SE
TUMWATER, WA 98501-5271
Phone number: 360-704-7170
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Mailing Address
MARK GRANNEMANN
921 14TH AVE
LONGVIEW, WA 98632-2316
Phone number: 360-423-0203
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