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Individual

BRITANIA RAQUEL ISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUDPT

Contact information

Practice address
1415 LUMSDEN RD, PORT ORCHARD, WA 98367-9179
(360) 873-9430
(360) 876-0731
Mailing address
1415 LUMSDEN RD, PORT ORCHARD, WA 98367-9179
(360) 873-9430
(360) 876-0731

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BHA.FS.60892207
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1518183763
WA
Enumeration date
03/27/2020
Last updated
03/27/2020
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