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Individual

DELLA AGBAVON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
401 BROADWAY STE 100, TACOMA, WA 98402-3900
(206) 880-1359
Mailing address
3800A BRIDGEPORT WAY W STE 244, UNIVERSITY PLACE, WA 98466-4416

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LW60944792
WA
1041C0700X
Clinical Social Worker
Primary
LW60944792
WA

Other

Enumeration date
12/30/2020
Last updated
03/18/2021
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