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1699391573
GUADALUPE V BAZAN
YAKIMA, WA
NPI
1699391573
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA 60914407)
Enumeration Date
2020-06-17
Last Update Date
2020-06-17
Business Address
Mr. GUADALUPE V BAZAN SUDPT
609 W LOGAN AVE
YAKIMA, WA 98902-5553
Phone number: 509-367-1674
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Mailing Address
Mr. GUADALUPE V BAZAN SUDPT
609 W LOGAN AVE
YAKIMA, WA 98902-5553
Phone number: 509-367-1674
Copy
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