Individual
DUSTIN MARTIN AVILA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SUDP-T
Contact information
Practice address
3209 N 7TH ST, TACOMA, WA 98406-5905
(408) 310-2062
Mailing address
3209 N 7TH ST, TACOMA, WA 98406-5905
(408) 310-2062
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
61472800
WA
Other
Enumeration date
09/12/2023
Last updated
09/12/2023
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