Individual
THIERRY BUCKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
2400 BRISTOL COURT SW, OLYMPIA, WA 98502
(360) 357-2482
Mailing address
2400 BRISTOL CT SW, OLYMPIA, WA 98502-6004
(360) 357-2482
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60010886
WA
Other
Enumeration date
06/09/2017
Last updated
07/21/2022
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