Provider Demographics
NPI:1467710764
Name:CURTIS, KEVIN E (CDP)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:E
Last Name:CURTIS
Suffix:
Gender:M
Credentials:CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6334 LITTLEROCK RD. SW
Mailing Address - Street 2:BLDG #6
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512
Mailing Address - Country:US
Mailing Address - Phone:360-704-7590
Mailing Address - Fax:360-704-7591
Practice Address - Street 1:6334 LITTLEROCK RD. SW
Practice Address - Street 2:BLDG #6
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512
Practice Address - Country:US
Practice Address - Phone:360-704-7590
Practice Address - Fax:360-704-7591
Is Sole Proprietor?:No
Enumeration Date:2012-04-25
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60099087101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)