Individual
BRAXTON DANIEL LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAC
Contact information
Practice address
811 MADISON ST, EVERETT, WA 98203-4543
(425) 212-4200
(425) 212-4220
Mailing address
PO BOX 2569, EVERETT, WA 98213-0569
(425) 212-4200
(425) 212-4220
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/25/2023
Last updated
05/04/2023
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