Provider Demographics
NPI:1619411824
Name:CURRIE, KEVIN J
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:J
Last Name:CURRIE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N TACOMA AVE APT 802
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-2622
Mailing Address - Country:US
Mailing Address - Phone:253-347-1534
Mailing Address - Fax:253-922-6955
Practice Address - Street 1:5005 PACIFIC HWY E
Practice Address - Street 2:SUITE 20
Practice Address - City:FIFE
Practice Address - State:WA
Practice Address - Zip Code:98424-2655
Practice Address - Country:US
Practice Address - Phone:253-922-6522
Practice Address - Fax:253-922-6955
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP 60475321101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)