Organization
CORAM DEO COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTEO D YEPES LICSW (OWNER/MANAGER)
(206) 679-0531
Entity
Organization
Contact information
Practice address
430 SE GOSNELL LN, SHELTON, WA 98584-8384
(206) 679-0531
Mailing address
430 SE GOSNELL LN, SHELTON, WA 98584-8384
(206) 679-0531
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
09/09/2024
Last updated
09/09/2024
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