Individual
MS. CIANA ENIZ BUSTILLO LUNA I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
(206) 461-3614
Mailing address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/22/2018
Last updated
03/22/2018
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