Marcel Anton Ettesvold
Peer Specialist in Kennewick, WA. Individual provider (NPI-1).
NPI number1669949368
StatusActive
Last updated in NPPESAug 29, 2019
Details
- NPI
- 1669949368
- Entity type
- Individual (NPI-1)
- Name
- Marcel Anton Ettesvold
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 31, 2018
- Last updated
- Aug 29, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | CG60817318 | WA | Yes |
Practice location
3321 W Kennewick Ave Ste 150Kennewick, WA 99336-2968
Phone 509-783-2085
Mailing address
3321 W Kennewick Ave Ste 150Kennewick, WA 99336-2968
Phone 509-735-6446
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