Individual
KATRINA CUSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2428 W REYNOLDS AVE, CENTRALIA, WA 98531-4554
(360) 330-9044
Mailing address
2428 W REYNOLDS AVE, CENTRALIA, WA 98531-4554
(360) 330-9044
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
CG61029831
WA
Other
Enumeration date
12/17/2019
Last updated
01/07/2025
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