Individual
ADDISON MARIE IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 194TH ST SW STE 100, LYNNWOOD, WA 98036-4613
(425) 426-2761
Mailing address
21600 OXNARD ST STE WOODLAND, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
(818) 758-8015
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
WDL13675023B
WA
Other
Enumeration date
11/19/2021
Last updated
11/19/2021
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