Individual
KELLIE VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
1302 W GARDNER AVE, SPOKANE, WA 99201-2059
(509) 503-6010
Mailing address
7440 W MARGINAL WAY S, SEATTLE, WA 98108-4141
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/06/2021
Last updated
12/07/2021
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