Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 60655873 | WA |
NPI | 1003263203 |
---|---|
Provider Name | Steven Schrock |
First Address | Kirkland, WA 98033-8827 |
Second Address | Kirkland, WA 98033-8827 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2016 |
Last Update Date | 17/05/2016 |