Individual provider · Type 1 NPI

Lola Jett, SUDP

Addiction (Substance Use Disorder) Counselor · Shoreline, WA

NPI number 1629463617 Active

Practice location

16715 Aurora Ave N # 102
Shoreline, WA 98133-5310

Mailing address

2610 Wetmore Ave
Everett, WA 98201-2927

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor 101YA0400X60763564 (WA)
Addiction (Substance Use Disorder) Counselor 101YA0400XCP60763564 (WA)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCO 60521530 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1629463617

Lola Jett, SUDP's National Provider Identifier is 1629463617, issued on Apr 6, 2015. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Shoreline, WA. The record was last updated on Oct 22, 2021.