Individual
MAXIMO MORENO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO 60653500
Contact information
Practice address
5007 CLAREMONT WAY, EVERETT, WA 98203-3321
(425) 609-5504
(425) 609-5506
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
(206) 764-0502
(206) 764-0516
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1174784185
WA
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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