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Organization

CITY UNIVERSITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL THEISEN LMHC (PROGRAM DIRECTOR)
(206) 239-4762
Entity
Organization

Contact information

Practice address
2313 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-3841
(253) 503-9035
Mailing address
2313 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-3841
(253) 503-9035

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
WA

Other

Enumeration date
06/11/2013
Last updated
06/11/2013
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