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Individual

MR. JEREMIAH THUNDERWALKER SAUCIER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SUDP

Contact information

Practice address
8717 S HOSMER ST, TACOMA, WA 98444-1819
(253) 473-7474
Mailing address
8717 S HOSMER ST, TACOMA, WA 98444-1819
(253) 473-7474

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60117863
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO60117863
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
01
RC60098609
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
11/06/2009
Last updated
04/12/2022
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