Individual
STACY JEAN EVANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
901 RAINIER AVE S, SEATTLE, WA 98144-2839
(206) 889-0569
Mailing address
821 SW 135TH ST, BURIEN, WA 98146-3147
(206) 391-3563
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP60390363
CDP
WA
Enumeration date
01/02/2018
Last updated
01/02/2018
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