Individual
MARY LOUSIE MCEUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SUDPT
Contact information
Practice address
4841 AUTO CENTER WAY STE 101, BREMERTON, WA 98312-4388
(360) 373-1529
Mailing address
4841 AUTO CENTER WAY STE 101, BREMERTON, WA 98312-4388
(360) 373-1529
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1990365
—
WA
Enumeration date
12/16/2021
Last updated
12/16/2021
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