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Individual

DESTIN RAE MARTINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SUDP

Contact information

Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 748-4776
Mailing address
9474 LATHROP INDUSTRIAL DR SW, TUMWATER, WA 98512-1109
(360) 583-3340
(360) 322-3804

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61210725
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2077844
WA
Enumeration date
01/27/2022
Last updated
12/04/2024
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