Individual
DALLAS R COURSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
851 POPLAR PL S, SEATTLE, WA 98144-2827
(206) 322-2387
Mailing address
15508 FAIR OAKS DR S, SPANAWAY, WA 98387-9051
(307) 871-9786
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61361005
WY
Other
Enumeration date
10/24/2022
Last updated
06/27/2023
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