Conrad Slater, LCO
in Olympia, WA. Individual provider (NPI-1).
NPI number1851028518
StatusActive
Last updated in NPPESAug 3, 2022
Details
- NPI
- 1851028518
- Entity type
- Individual (NPI-1)
- Name
- Conrad Slater
- Credential
- LCO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 3, 2022
- Certification date
- Aug 3, 2022
- Last updated
- Aug 3, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Z00000X | 61272281 | WA | Yes |
Practice location
3508 12th Ave NeOlympia, WA 98506-5218
Phone 360-459-1099
Mailing address
252 Broadway Apt 510Tacoma, WA 98402-4003
Phone 540-931-8478
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