Individual
JERRY EUGENE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
15 S GRADY WAY STE 310, RENTON, WA 98057-3215
(425) 652-1886
Mailing address
7832 196TH ST SW, #15, EDMONDS, WA 98026-6556
(425) 652-1886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
RC00015663
WA
Other
Enumeration date
10/24/2007
Last updated
07/12/2019
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