Individual
QUINCY T JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
10322 NE 132ND STREET, KIRKLAND, WA 98034-9803
(425) 823-3116
Mailing address
10322 NE 132ND STREET, KIRKLAND, WA 98034
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP6051684
WA
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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