Individual
KEIRA L MCCLOSKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
15314 NE DOLE VALLEY RD, YACOLT, WA 98675-9521
(360) 260-6300
Mailing address
15314 NE DOLE VALLEY RD, YACOLT, WA 98675-9521
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61040174
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077844
—
WA
Enumeration date
01/27/2022
Last updated
01/27/2022
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