Individual
MISS CHARNELLE L BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 SW HOLDEN ST, SEATTLE, WA 98126-3505
(206) 933-7055
Mailing address
2600 SW HOLDEN ST, SEATTLE, WA 98126-3505
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
Primary
—
WA
Other
Enumeration date
11/02/2019
Last updated
11/02/2019
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