Individual
BEVERLY SURFACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3322 BROADWAY, EVERETT, WA 98201
(425) 349-7289
(425) 349-7288
Mailing address
5618 100TH PL NE, MARYSVILLE, WA 98270-6634
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC00019799
WA
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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