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1750916086
OZARK GORE
LACEY, WA
NPI
1750916086
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103TA0400X Psychologist, Addiction (Substance Use Disorder)
Enumeration Date
2020-03-06
Last Update Date
2020-03-06
Business Address
OZARK GORE
4804 LACEY BLVD SE STE A
LACEY, WA 98503-5733
Phone number: 360-799-5782
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Mailing Address
OZARK GORE
6703 OAKBROOK CT SE
OLYMPIA, WA 98513-5672
Phone number: 808-214-4948
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