Individual
DERRICK SIVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 24TH AVE S, SEATTLE, WA 98144-4637
(206) 382-5340
Mailing address
2100 24TH AVE S, SEATTLE, WA 98144-4637
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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