Viphonsack Mark Kaseumsouk

NPI #1043777675 in Tacoma, Washington

Provider Information

NPI Number: 1043777675
Entity Type: Individual
Name: Viphonsack Mark Kaseumsouk
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor
Enumeration Date: Mar 1, 2019
Last Updated: Mar 1, 2019

Practice Location

Address: 1201 S PROCTOR ST
City: Tacoma
State: Washington
ZIP Code: 98405-2047
Phone: (253) 396-5800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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