Individual
MR. MARK L ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP, BA, ICRC
Contact information
Practice address
4600 36TH AVE SW, #412, SEATTLE, WA 98126-2794
(206) 419-5664
Mailing address
4600 36TH AVE SW, #412, SEATTLE, WA 98126-2794
(206) 419-5664
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP 60073428
WA
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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