Individual
BRIAN T WATERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
15455 65TH AVE S, TUKWILA, WA 98188-2534
(206) 721-5170
(206) 721-6288
Mailing address
15455 65TH AVE S, TUKWILA, WA 98188-2534
(206) 721-5170
(206) 721-6288
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00003772
WA
Other
Enumeration date
11/03/2011
Last updated
10/01/2012
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