Individual
ANTHONY AVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5455 ALMIRA DR NE, BREMERTON, WA 98311-8330
(460) 479-4994
Mailing address
5455 ALMIRA DR NE, BREMERTON, WA 98311-8330
(460) 479-4994
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60164496
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG60164496
AGENCY AFFILIATED COUNSELOR
WA
Enumeration date
09/16/2015
Last updated
09/16/2015
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