Individual
GILBERTO MALDONADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSWA, CDPT
Contact information
Practice address
6334 LITTLEROCK RD SW, TUMWATER, WA 98512-7332
(360) 704-7590
Mailing address
3808 CAMERON DR NE, LACEY, WA 98516-3888
(360) 628-9205
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
60618670
WA
1041C0700X
Clinical Social Worker
Primary
60616317
WA
Other
Enumeration date
07/06/2017
Last updated
07/06/2017
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