Individual
APRIL D BACONGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
500 SE WASHINGTON ST, CHEHALIS, WA 98532
(509) 232-5766
(509) 321-5472
Mailing address
12715 E MISSION AVE, SPOKANE VALLEY, WA 99216-1027
(509) 232-5766
(509) 321-5472
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
NC60590351
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077844
—
WA
Enumeration date
02/08/2019
Last updated
02/08/2019
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