Individual
AXEL DANIE GALLARDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDPT
Contact information
Practice address
113 23RD AVE S, SEATTLE, WA 98144-2309
(206) 709-1777
Mailing address
113 23RD AVE S, SEATTLE, WA 98144-2309
(206) 709-1777
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61360511
WA
Other
Enumeration date
01/11/2023
Last updated
01/11/2023
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