Individual
BRODY TUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 558-2456
Mailing address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW65719
CA
Other
Enumeration date
03/02/2015
Last updated
12/22/2021
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