Individual
BRIANNA LEEANN FUENTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 SE WASHINGTON AVE, CHEHALIS, WA 98532-3058
(360) 507-8032
Mailing address
12715 E MISSION AVE, SPOKANE VALLEY, WA 99216-1027
(360) 507-8032
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NC61050207
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2109227
—
WA
Enumeration date
10/06/2021
Last updated
10/06/2021
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