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Individual

MR. BRUCE WILLIAM PERHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LICSW

Contact information

Practice address
5100 S DAWSON ST STE 103, SEATTLE, WA 98118-2100
(206) 973-6152
Mailing address
5100 S DAWSON ST STE 103, SEATTLE, WA 98118-2100
(206) 973-6152

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SWI.LW.60765129
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SWI.LW.60765129
STATE OF WASHINGTON
WA
Enumeration date
10/02/2017
Last updated
10/02/2017
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