Individual
JOHNETTE FABRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CP 00002876
Contact information
Practice address
1016 S 28TH ST, TACOMA, WA 98409-8020
(253) 680-2691
Mailing address
1016 S 28TH ST, TACOMA, WA 98409-8020
(253) 680-2691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP 00002876
WA
Other
Enumeration date
01/27/2016
Last updated
01/28/2016
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