Individual
MR. BRADLEY STEPHEN KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDP
Contact information
Practice address
221 E WASHINGTON AVE, DAYTON, WA 99328-1317
(509) 382-1164
(509) 382-1164
Mailing address
221 E WASHINGTON AVE, DAYTON, WA 99328-1317
(509) 382-1164
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60783264
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
60113996
WA
Other
Enumeration date
11/07/2017
Last updated
12/17/2018
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