Individual
LACEY JOSEPHSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
2924 FALK RD, VANCOUVER, WA 98661-5604
(360) 750-9588
(360) 750-9718
Mailing address
2924 FALK RD, VANCOUVER, WA 98661-5604
(360) 750-9588
(360) 750-9718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60472102
WA
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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