Individual
LADONYA S TICESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 257-6600
(206) 257-6825
Mailing address
1210 SW 136TH ST, BURIEN, WA 98166-1214
(206) 257-6600
(206) 257-6600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60625599
WA
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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