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Individual

BRIAN OR'DEAL CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CDPT

Contact information

Practice address
1116 SUMMIT AVE, SEATTLE, WA 98101-2831
(206) 323-0930
Mailing address
1116 SUMMIT AVE, SEATTLE, WA 98101-2831
(206) 323-0930

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO 60108458
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CO 60108458
CHEMICAL DEPENDENCY PROFESSIONAL TRAINEE
WA
Enumeration date
03/30/2012
Last updated
03/30/2012
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