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Kenneth Stephen Bourque, CDPT
Addiction (Substance Use Disorder) Counselor in Tacoma, Washington
NPI 1326602822

Kenneth Stephen Bourque is an Addiction (Substance Use Disorder) Counselor based in Lacey, WA and is specialized in Addiction (Substance Use Disorder). Kenneth Stephen Bourque practices in Tacoma, WA and has the professional credentials of CDPT. The NPI Number for Kenneth Stephen Bourque is 1326602822 and holds a License No. 60833994 (Washington).

The current practice location address for Kenneth Stephen Bourque is 5915 Orchard St W, Tacoma, WA and can be reached out via phone at 253-414-7461 and via fax at 253-627-8387.

Location: 5915 Orchard St W, Tacoma, WA, 98503-2150
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Provider Profile Details
NPI Number
1326602822
Provider Name
Kenneth Stephen Bourque
Credential
CDPT
Provider Entity Type
Individual
Gender
Male
Address
5915 Orchard St W, Tacoma, WA, 98503-2150
Phone Number
253-414-7461
Fax Number
253-627-8387
Provider Enumeration Date
04/30/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
60833994 01 WA WASHINGTON STATE DEPARTMENT OF HEALTH
institution
Provider Business Practice Location Address Details
Address
5915 Orchard St W
City
State
Zip
98467-3824
Phone Number
253-414-7461
Fax Number
253-627-8387
person
Provider Business Mailing Address Details
Address
5915 Orchard St W
City
State
Zip
98467-3824
Phone Number
253-414-7461
Fax Number
253-627-8387
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
60833994 (Washington)
Definition
Definition to come...
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