Individual
ILEANA JANOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDP
Contact information
Practice address
1901 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144-4801
(206) 322-7676
(206) 726-7585
Mailing address
1901 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144-4801
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP000005557
WA
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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