Individual
TEWANA Y. MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
17500 SE 392ND ST, AUBURN, WA 98092-9705
(253) 939-6648
Mailing address
17500 SE 392ND ST, AUBURN, WA 98092-9705
(253) 939-6648
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00003063
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP00003063
LICENSE
WA
Enumeration date
03/11/2008
Last updated
03/11/2008
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