Individual
KELLY BUECHEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
409 CUSTER WAY SE, SUITE D, TUMWATER, WA 98501-3350
(360) 570-8258
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60449931
WA
Other
Enumeration date
08/13/2015
Last updated
08/13/2015
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