Provider Demographics
NPI:1497525273
Name:KLAWITTER, SOLONGO (SUDPT)
Entity Type:Individual
Prefix:MISS
First Name:SOLONGO
Middle Name:
Last Name:KLAWITTER
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:SOLONGO
Other - Middle Name:DAVAA-OCHIR
Other - Last Name:KLAWITTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SOLONGO DAVAA-OCHIR
Mailing Address - Street 1:9100 BRIDGEPORT WAY SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2427
Mailing Address - Country:US
Mailing Address - Phone:253-439-9997
Mailing Address - Fax:
Practice Address - Street 1:9100 BRIDGEPORT WAY SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2427
Practice Address - Country:US
Practice Address - Phone:253-439-9997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO60708045101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)