Individual
MR. KIRK RICHARD GRESHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, LMFT
Contact information
Practice address
1206 WATER ST, PORT TOWNSEND, WA 98368-6725
(360) 379-0911
Mailing address
1206 WATER ST, PORT TOWNSEND, WA 98368-6725
(360) 379-0911
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF00001440
WA
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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