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1922595503
ISMAEL CHAVEZ
TUMWATER, WA
NPI
1922595503
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CP60594955)
Enumeration Date
2018-04-18
Last Update Date
2018-04-18
Business Address
Mr. ISMAEL CHAVEZ BA, CDP
6005 TYEE DR SW
TUMWATER, WA 98512-7356
Phone number: 360-209-5422
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Mailing Address
Mr. ISMAEL CHAVEZ BA, CDP
6005 TYEE DR SW
TUMWATER, WA 98512-7356
Phone number: 360-209-5422
Copy
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