Individual
KELLY KNITTLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4820 SHE-NAH-NUM DR. SE, OLYMPIA, WA 98520
(360) 413-2727
Mailing address
4820 SHE NAH NUM DR SE, OLYMPIA, WA 98513-9105
(360) 413-2727
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60523464
WA
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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