Individual
ESTANISLAO MAHAN IRAOLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17018 15TH AVE NE, SHORELINE, WA 98155-5126
(206) 362-7282
Mailing address
17018 15TH AVE NE, SHORELINE, WA 98155-5126
(206) 362-7282
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/12/2017
Last updated
10/12/2017
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