Individual
DR. DEBORAH CORLEY WENTWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3726 PACIFIC AVE SE STE A, OLYMPIA, WA 98501-2170
(360) 229-1114
Mailing address
220 W COTA ST # 257, SHELTON, WA 98584-2264
(360) 229-1114
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY00003126
WA
Other
Enumeration date
05/17/2006
Last updated
07/08/2007
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