Individual
TY MATHEW BOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
933 E 1ST ST, PORT ANGELES, WA 98362-4012
(360) 452-4432
(360) 452-4599
Mailing address
2851 LOWER ELWHA RD, PORT ANGELES, WA 98363-8409
(360) 452-4432
(360) 452-4459
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60646563
WA
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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