Individual
CLYDE DANIEL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
375 SW 11TH ST, CHEHALIS, WA 98532-4700
(360) 740-3534
Mailing address
375 SW 11TH ST, CHEHALIS, WA 98532-4700
(360) 740-3534
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60248171
WA
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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