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Individual

JESSICA LARREINAGA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CO60972165

Contact information

Practice address
4928 109TH ST SW, LAKEWOOD, WA 98499-3731
(253) 473-7474
(253) 474-9724
Mailing address
831 E 52ND ST, TACOMA, WA 98404-2702
(253) 590-9549

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO609720165
WA

Other

Enumeration date
05/12/2020
Last updated
05/12/2020
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