Individual
GLEN BENJAMIN PADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
4007 BRIDGEPORT WAY W, SUITE F2, UNIVERSITY PLACE, WA 98466-4330
(253) 565-2208
Mailing address
16513 133RD PL SE, RENTON, WA 98058-6968
(206) 619-7734
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF00001755
WA
Other
Enumeration date
01/07/2010
Last updated
01/07/2010
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