Individual
NATHAN EZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
839 SW 126TH ST, BURIEN, WA 98146-2752
(215) 692-3049
Mailing address
839 SW 126TH ST, BURIEN, WA 98146-2752
(215) 692-3049
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SW124649
—
1041C0700X
Clinical Social Worker
Primary
LW60951940
WA
Other
Enumeration date
12/03/2012
Last updated
09/08/2022
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