Individual
RANDALL SCOTT SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CO 60585012
Contact information
Practice address
742 PACIFIC ST, SEDRO WOOLLEY, WA 98284-2021
(360) 826-2661
Mailing address
1601 E COLLEGE WAY, MOUNT VERNON, WA 98273-5612
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO 60585012
WA
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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