Individual
CARLY HEATHER GUTIERREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 BLACK LAKE BLVD SW, OLYMPIA, WA 98502-7207
(360) 878-8248
Mailing address
907 7TH AVE SW, TUMWATER, WA 98512-6820
(360) 790-4044
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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