Organization
KELLY DRUIN SIEVERTSON, LICSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SIEVERTSON MSW,LICSW (OWNER)
(206) 486-0295
Entity
Organization
Contact information
Practice address
316 MAIN ST, SUITE B, EDMONDS, WA 98020-3197
(206) 486-0295
Mailing address
316 MAIN ST, SUITE B, EDMONDS, WA 98020-3197
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
LW60229562
WA
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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