Individual
JEROME WALTERS SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
3715 S 141ST ST APT 6, TUKWILA, WA 98168-4049
(206) 747-6446
Mailing address
PO BOX 48322, SEATTLE, WA 98148-0322
(206) 747-6446
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
00006135
WA
Other
Enumeration date
01/03/2015
Last updated
01/03/2015
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