Individual
TAYA M WALLENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 E COLLEGE WAY, MOUNT VERNON, WA 98273-5612
(206) 461-4880
Mailing address
4905 61ST DR NE, MARYSVILLE, WA 98270-7552
(425) 903-1361
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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