Individual
MISS MARY A BOLENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO61603715SUDPT
Contact information
Practice address
506 W FRANKLIN ST, SHELTON, WA 98584-3517
(360) 427-5232
(360) 740-1877
Mailing address
PO BOX 59, CHEHALIS, WA 98532-0059
(360) 740-4380
(360) 740-1877
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CO61603715
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61603715
WA
Other
Enumeration date
12/03/2024
Last updated
03/11/2026
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