| Doctor Name: | MARK A. WALRATH |
| NPI Number: | 1336430362 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC, CDP |
| License Number: | CP00003467 |
| Business Practice Address: | 918 Alder Ave Sumner, WA - 983901406 |
| Business Phone Number: | 2538912662 |
| Business Fax Number: | 2538911044 |
| Mailing Address: | 918 Alder Ave, SUMNER |
| State: | WA |
| Postal Code: | 983901406 |
| Phone Number: | 2538912662 |
| Fax Number: | 2538911044 |
| NPI Enumeration Date: | 04/25/2011 |
| NPI Last Update Date: | 04/25/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CP00003467 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |