Individual
MR. LAWRENCE GRAHAM BUCKLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
3810 196TH ST SW STE 11, LYNNWOOD, WA 98036-5746
(425) 248-4900
(425) 248-4703
Mailing address
P O BOX 12598, EVERETT, WA 98201
(425) 248-4900
(425) 248-4703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00004052
WA
Other
Enumeration date
03/28/2016
Last updated
03/28/2016
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