Individual
DEREK ANTHONY DUARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5915 ORCHARD ST W, TACOMA, WA 98467-3824
(253) 414-7461
Mailing address
4302 CENTER ST APT X106, TACOMA, WA 98409-8620
(650) 669-4194
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60967188
WA
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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