Individual
LACEY WHEELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, CDP
Contact information
Practice address
1600 S COLUMBIAN WAY, SEATTLE, WA 98108-1565
(206) 227-1287
(206) 764-2192
Mailing address
1600 S COLUMBIAN WAY, SEATTLE, WA 98108-1565
(206) 227-1287
(206) 764-2192
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP60249692
WA
104100000X
Social Worker
Primary
SC60643039
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP60249692
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
01
—
SC60643039
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
09/08/2016
Last updated
09/08/2016
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