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Individual

MS. BETSI ELAINA SHARI THORNTON KUKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CDP

Contact information

Practice address
2528 WHEATON WAY, STE 106, BREMERTON, WA 98310-3305
(360) 782-1933
Mailing address
PO BOX 425, BURLEY, WA 98322-0425
(360) 440-0476

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CD00006271
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101YA0400X
WASHINGTON STATE
WA
Enumeration date
03/23/2009
Last updated
03/23/2009
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