Individual
JOSSIE NICHELLE BUNTEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
12850 LALA COVE LN SE, OLALLA, WA 98359-9664
(253) 857-6201
(253) 857-3993
Mailing address
12850 LALA COVE LN SE, OLALLA, WA 98359-9664
(253) 857-6201
(253) 857-3993
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60940373
WA
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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