IndividualActive
Boss White
NPI 1780384602 · Professional Counselor · Lakewood, WA
Provider details
- NPI number
- 1780384602
- Entity type
- Individual
- Primary specialty
- Professional CounselorBehavioral Health & Social Service Providers
- Sex
- Male
- Sole proprietor
- No
- License
- MC61427113 (WA)
Practice location
9125 Bridgeport Way Sw Ste 102
Lakewood, WA 98499-2448
Phone: (253) 215-2836
Fax: (253) 366-7422
Mailing address
9125 Bridgeport Way Sw Ste 102
Lakewood, WA 98499-2448
Registry dates
- Enumerated
- 2023-03-08
- Last updated
- 2024-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.