Individual
TANYA FAYE GLEASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
811 MADISON ST, EVERETT, WA 98203-4543
(425) 212-4200
Mailing address
PO BOX 2569, EVERETT, WA 98213-0569
(425) 212-4200
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60508273
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60366272
WA
Other
Enumeration date
10/11/2013
Last updated
10/07/2014
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