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Individual

DAVID D GERARDOT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 COOPER POINT RD SW, BLDG. #17, OLYMPIA, WA 98502-1178
(360) 352-1668
Mailing address
1800 COOPER POINT RD SW, BLDG. #17, OLYMPIA, WA 98502-1178
(360) 352-1668

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH00003805
WA
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
Primary
AP30006965
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G8856848
GROUP PIN
Enumeration date
03/17/2008
Last updated
03/13/2009
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