Individual
TOMAS D MINO PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDPT60922995
Contact information
Practice address
151 N MARKET BLVD STE C, CHEHALIS, WA 98532-2677
(360) 948-0203
(360) 262-6703
Mailing address
121 NW CHEHALIS AVE, CHEHALIS, WA 98532-2010
(360) 948-0203
(360) 262-6703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1376696096
WA
Other
Enumeration date
05/10/2019
Last updated
05/24/2019
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