Individual
MR. MICHAEL DWAYNE ROOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LMFT
Contact information
Practice address
719 SLEATER KINNEY RD SE STE 212, LACEY, WA 98503-1138
(360) 519-4256
Mailing address
719 SLEATER KINNEY RD SE STE 212, LACEY, WA 98503-1138
(360) 519-4256
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF 60497884
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2069009
—
WA
Enumeration date
12/18/2009
Last updated
11/22/2017
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