Individual
MRS. KIMBERLY KAY KRUSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO 60739297
Contact information
Practice address
1415 LUMSDEN RD, PORT ORCHARD, WA 98367-9179
(360) 876-9430
Mailing address
1415 LUMSDEN RD, PORT ORCHARD, WA 98367-9179
(360) 876-9430
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60739297
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO60739297
DEPARTMENT OF HEALTH
WA
Enumeration date
10/31/2018
Last updated
10/31/2018
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