Individual
CELIA RAE GONZALEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 E MAIN ST STE 600, OTHELLO, WA 99344-1146
(509) 488-4074
(509) 488-0166
Mailing address
425 E MAIN ST STE 600, OTHELLO, WA 99344-1146
(509) 488-4074
(509) 488-0166
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG61152603
WA
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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