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Individual

HAEMAN SONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CDP

Contact information

Practice address
560 QUILEUTE HEIGHTS, LAPUSH, WA 98350
(360) 374-6076
(360) 374-5014
Mailing address
PO BOX 279, LA PUSH, WA 98350-0279
(360) 374-6076
(360) 374-5014

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00006142
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7084486
WA
Enumeration date
08/28/2007
Last updated
08/28/2007
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