Individual
CARLY ROSE KURTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 S PROCTOR ST, TACOMA, WA 98405-2047
(253) 296-5800
Mailing address
1201 S PROCTOR ST, TACOMA, WA 98405-2047
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101Y00000X
—
WA
Enumeration date
10/31/2017
Last updated
10/31/2017
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