Individual
MR. CHARLES MARTIN BULLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
2206 QUEEN ANNE AVE N, #203, SEATTLE, WA 98109-2370
(206) 283-4360
Mailing address
2206 QUEEN ANNE AVE N, #203, SEATTLE, WA 98109-2370
(206) 283-4360
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
020704-LW00006183
WA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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