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Individual

CHRISTIAN BALTAZAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4238 AUBURN WAY N, AUBURN, WA 98002-1311
(206) 941-6543
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
D4754505
CA
Enumeration date
04/09/2018
Last updated
12/03/2024
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