Individual
ERMA LUS MEDINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
605 PARK AVE, GRANDVIEW, WA 98930-1534
(509) 830-4624
Mailing address
605 PARK AVE, GRANDVIEW, WA 98930-1534
(509) 830-4624
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60906253
WA
Other
Enumeration date
05/17/2021
Last updated
05/17/2021
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