Individual
KATIE A VAN KOMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
1206 N DOLARWAY RD STE 114, ELLENSBURG, WA 98926-8392
(509) 457-5653
Mailing address
201 E LINCOLN AVE STE 100, YAKIMA, WA 98901-2348
(509) 457-5653
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60767403
WA
Other
Enumeration date
12/26/2018
Last updated
12/26/2018
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