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Individual

TIFFANY BREANNA VOGT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LSWAIC, CDPT

Contact information

Practice address
2329 4TH AVE, SEATTLE, WA 98121-1717
(206) 461-3649
Mailing address
2329 4TH AVE, SEATTLE, WA 98121-1717
(206) 461-3649

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60645320
WA
101YP2500X
Professional Counselor
Primary
SC60781785
WA

Other

Enumeration date
03/15/2018
Last updated
03/15/2018
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