Individual
DR. JOSEPH R ETHERAGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
BLDG 9040 FITZSIMMONS DRIVE, TACOMA, WA 98431-0001
(253) 968-2751
Mailing address
3047 OLD PORT LN NW, OLYMPIA, WA 98502-3963
(360) 481-7081
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
981
AL
Other
Enumeration date
05/01/2006
Last updated
07/08/2007
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