Individual
CONNIE J DERUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5133 TURKINGTON RD, ACME, WA 98220-9638
(206) 251-4776
Mailing address
PO BOX 98, ACME, WA 98220-0098
(206) 251-4776
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
60303063
WA
Other
Enumeration date
07/31/2019
Last updated
07/31/2019
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