Individual
AMIE OTTERNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACC
Contact information
Practice address
135 W MAIN ST, CHEHALIS, WA 98532-4817
(360) 748-6696
Mailing address
PO BOX 1445, CHEHALIS, WA 98532-0378
(360) 748-6696
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CG60151248
WA
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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