Individual
MR. PHILLIP FUNDERBURK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP
Contact information
Practice address
4301 HOYT AVE, EVERETT, WA 98203-2316
(877) 522-1275
Mailing address
1550 4TH AVE S, SEATTLE, WA 98134-1510
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60691952
WA
Other
Enumeration date
01/27/2016
Last updated
06/30/2023
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