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General NPI Number Information
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NPI Number | 1124377544
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Entity Type | Individual
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Provider Name | MICHAEL A WEBSTER CDP
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Gender | Male
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 17600 TALBOT RD S SUITE 3
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City | RENTON
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State | WA
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Zip | 98055-5788
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Country | US
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Telephone | 425-254-2899
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Fax | 425-254-2522
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Provider Business Mailing Address
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Address Line | PO BOX 39199
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City | LAKEWOOD
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State | WA
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Zip | 98496-3199
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Country | US
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Telephone | 425-254-2899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CP00000140
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License Number State | WA
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