Individual
STACY ALAN ROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT
Contact information
Practice address
1960 THOMPSON DR, SEDRO WOOLLEY, WA 98284-5007
(360) 856-3140
Mailing address
7440 W MARGINAL WAY S, SEATTLE, WA 98108-4141
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60738252
WA
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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