Individual
TERA JOYCE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
112 S SOLMAR DR, SEQUIM, WA 98382
(360) 406-0794
Mailing address
112 S SOLMAR DR, SEQUIM, WA 98382-7522
(360) 406-0794
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60783252
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60185869
WA
Other
Enumeration date
11/07/2018
Last updated
08/13/2019
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