Individual
SEASON SILK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
523 RAINIER ST, LA CONNER, WA 98257-4707
(360) 840-1970
Mailing address
523 RAINIER ST, LA CONNER, WA 98257-4707
(360) 840-1970
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61086168
WA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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