Individual
MALISSA KAUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO61248684
Contact information
Practice address
4301 S PINE ST STE 92, TACOMA, WA 98409-7259
(253) 507-5334
(253) 330-5182
Mailing address
11127 10TH AVENUE CT E APT A303, PARKLAND, WA 98445-7081
(253) 592-4509
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61248684
WA
Other
Enumeration date
01/03/2024
Last updated
01/03/2024
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