Individual
BRUCE WAYNE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 TACOMA AVE S, TACOMA, WA 98402-5416
(253) 502-5416
Mailing address
510 TACOMA AVE S, TACOMA, WA 98402-5416
(253) 502-5416
(253) 272-6666
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60715316
WA
Other
Enumeration date
02/22/2018
Last updated
02/22/2018
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