Individual
MR. JOAQUIN ANTOINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2475 BETHEL RD SE, PORT ORCHARD, WA 98366-2490
(360) 876-9430
(360) 876-0713
Mailing address
17219 132ND ST NW, GIG HARBOR, WA 98329-5600
(253) 858-1600
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61036507
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61036507
—
WA
Enumeration date
02/16/2021
Last updated
02/16/2021
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