Individual
STACEY MORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1520 NE RIDDELL RD # 110, BREMERTON, WA 98310-3005
(360) 415-5870
Mailing address
5455 ALMIRA DR NE, BREMERTON, WA 98311-8330
(360) 415-5870
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60622827
WA
Other
Enumeration date
07/10/2018
Last updated
01/29/2020
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