Individual
MONZELL L LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
16550 177TH AVE SE, MONROE, WA 98272-1968
(360) 794-2400
Mailing address
16550 177TH AVE SE, MONROE, WA 98272-1968
(360) 794-2400
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00001608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077844
—
WA
Enumeration date
04/19/2019
Last updated
04/19/2019
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