Individual
VANESSA LYNN GAVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1128 BROADWAY ST, LONGVIEW, WA 98632-3831
(360) 261-6930
Mailing address
1128 BROADWAY ST, LONGVIEW, WA 98632-3831
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
03/21/2022
Last updated
03/22/2022
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