Individual
XAVIER BLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3737 N SHELTON SPRINGS RD, SHELTON, WA 98584-9105
(678) 814-7371
Mailing address
4211 QUAIL DR SE, LACEY, WA 98503-5504
(678) 814-7371
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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