Individual
MICHAEL ELLIS DASSOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
3143 DONNELLY DR SE, OLYMPIA, WA 98501-4994
(360) 888-7661
Mailing address
3143 DONNELLY DR SE, OLYMPIA, WA 98501-4994
(360) 888-7661
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60312432
WA
Other
Enumeration date
10/08/2015
Last updated
10/08/2015
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